Two's company, three's a crowd for embryo transfer

Triplets and quadruplets in Switzerland: comparison with singletons, and evolution over the last decade

“…A major issue in the incidence of higher multiple births is its evolution during the last three decades: the literature accounts for an increase of two-to nine-fold for triplets [12,13,14,17,19,23] and of two- [12] to twelve-fold [19] for quadruplets. This increase can be attributed to ovulationinducing hormones and ART.…”

Relationship and parenthood in IVF couples with twin and singleton pregnancies compared with spontaneous singleton primiparous couples—a prospective 5-year follow-up study

“…A focus of the debate has been to reduce multiple births, with the current focus on one embryo transfer to eliminate twin births (1)(2)(3)(4). Studies on the physical health of the IVF-treated mother and the child during pregnancy, delivery, and neonatal period shows high rates of cesarean section, premature births, children small for gestational age, and an increased risk for congenital malformations (2)(3)(4)(5).…”

Joint modeling of success and treatment discontinuation in in vitrofertilization programs: a retrospective cohort study

“…However, an association between success and a monopoly situation or competition between IVF centers has already been considered. Indeed, some studies have tested the association between an increasing number of multiple pregnancies and competition between IVF centers, the underlying hypothesis being that a greater number of embryos are transferred in centers that compete against various others, in order to maximize the chance of success [24,25]. Recently, a large American study, conducted in clinics performing ART between 1995 and 2001 ( n  = 2374 clinic-years), has examined the relationship between competition and clinic-level ART outcomes and practice patterns [26].…”