Prevention of multiple gestation in controlled ovarian stimulation: Introduction to Theme

Abstract

S23increase, and then raised to 150 IU. Human chorionic gonadotrophin (hCG) was withheld if there were three follicles >14 mm diameter. Using this protocol, BESST rates were approx 6%.We had one triplet birth in 510 COH-IUI cycles.Ovulation induction in Australia has used 37.5-50 IU FSH for at least 5 days, before any increase to 50 IU or 75 IU FSH. The hCG was withheld when there were three follicles >15 mm diameter, BESST rates with OI were 8-13% with 5-10% twins.These data contrast with US publications reporting 30% multiple pregnancy rates, with 8-9% triplets, quadruplets or quintuplets, from COH-IUI or OI. The rate of multiple pregnancy with OI is 'a grave disservice to patients'. 5 Reports from the USA suggest that multiple pregnancies and births result from OI and COH-IUI in approximately 40% of instances, and there are 'no guidelines '. 6 Wilcox et al. reported a BESST rate from 221 normal couples who were attempting pregnancy. 7 Urinary hCG was measured in 707 cycles and 112 births were assessed. The mean age was 26-30 years and BESST was 16%; this is similar to our own work.There were 155 pregnancies and 43 early pregnancy losses. Min et al.