Infertility Treatment and Multiple Birth Rates in Britain, 1938–94

Abstract

Trends in multiple birth rates are thought to have been substantially affected by subfertility treatments in the last 25 years, but there are few quantitative assessments of this. This paper examines trends in twin and higher multiple birth rates separately in Scotland, England and Wales and compares their course with corresponding multiple birth rates in the Oxford Record Linkage Study area, where the proportions following subfertility treatment are documented. National data on prescriptions for subfertility treatments reinforce the view that they have had a major effect on the trends, and currently perhaps 60% of triplet and higher order births and 15% of twins follow their use in Britain.

Frequency of Twin Births in Developed Countries

“…The rising multiple birth rates have been attributed to the higher proportion of mothers treated with ovu- 1 9 7 2 1 9 7 4 1 9 7 6 1 9 7 8 1 9 8 0 1 9 8 2 1 9 8 4 1 9 8 6 1 9 8 8 1 9 9 0 1 9 9 2 1 9 9 4 1 9 9 6 1 9 9 8 2 0 1 9 7 0 1 9 7 2 1 9 7 4 1 9 7 6 1 9 7 8 1 9 8 0 1 9 8 2 1 9 8 4 1 9 8 6 1 9 8 8 1 9 9 0 1 9 9 2 1 9 9 4 1 9 9 6 1 9 9 8 2 0 1 9 7 0 1 9 7 2 1 9 7 4 1 9 7 6 1 9 7 8 1 9 8 0 1 9 8 2 1 9 8 4 1 9 8 6 1 9 8 8 1 9 9 0 1 9 9 2 1 9 9 4 1 9 9 6 1 9 9 8 2 0 lation-inducing hormones, and partially attributed to in vitro fertilization (IVF) practice, such as in Japan (Imaizumi, 2003), England and Wales (Murphy et al, 1997;Platt et al, 2001), Italy (Terzera, 2002), the Netherlands (Tas, 1994;Steegers-Theunissen et al, 1998), Denmark and Sweden (Eriksson et al, 1995), and France (Blondel & Kaminsky, 2002;Pison & Couvert, 2004). In the last 30 years of the 20th century, twinning rates were higher in European countries, Canada and Australia than in east Asian countries.…”

Families with Children Conceived by Donor Insemination: A Follow‐Up at Age Twelve

“…A comparison group of 91 couples who had conceived a child naturally following a period of infertility was obtained through the Oxford Record Linkage Study (ORLS), which recorded detailed maternity information on all births that took place in National Health Service hospitals in the Oxfordshire and West Berkshire areas of England from 1965 to 1988. The information contained in the ORLS files for births from 1973 onward includes any history of subfertility treatment (Murphy et al, 1997). From these files, couples who had attended a fertility clinic at an Oxfordshire hospital were identified.…”

Dramatic reduction in triplet and higher order births in England and Wales

“…Rates of all multiple births in England and Wales have increased by more than 50% in the past two decades. Much of this upsurge has been attributed to the use of assisted reproductive technologies, 1 and there has been continuing debate over the optimal number of embryos to replace after in vitro fertilisation (IVF) treatment and the number of eggs to transfer in gamete intra‐fallopian transfer. Clinicians have tended to optimise the chance of successful implantation by increasing the number they replace, but the resulting rise in multiple births has been met with concern by the medical community.…”