Multiple pregnancy problem could be solved 'overnight'

A Swedish fertility specialist has told press at the annual conference of the European Society of Human Reproduction and Embryology (ESHRE) that the problem of multiple pregnancies following fertility treatments could be easily solved if doctors were not hesitant to act.

Dr Karl Nygren, professor of Obstetrics and Gynaecology at Sofiahemmet Hospital, Stockholm, compared the one per cent rate of multiple births following natural conception to the figures for assisted conception, where multiple births account for between 20 and 40 per cent of cases where ovarian stimulation, IVF or a combination of both were used.

He said that multiple births were a by-product of the desire to maximise treatment effectiveness and achieve the desired success rates. But he went on to say that multiple pregnancies increase the risk of babies being born prematurely, leading to a number of related problems. A French study presented at the ESHRE conference confirmed that multiple pregnancies posed major risks to the health of babies.

However, Nygren said that 'doctors and patients are beginning to realise that the incidence of multiple pregnancy must be reduced. To maintain efficacy we need to make a better selection of viable embryos and to identify patients at highest risk for multiple pregnancy'. But he warned that fetal reduction in early pregnancy was not the solution to the multiple birth problem, due to ethical problems and psychological problems it could cause. He argued that the multiple pregnancy problem could be 'solved overnight if doctors had the will. Although multiple pregnancies are driven by a number of factors they are essentially iatrogenic - caused by doctors'. He suggested the transferral of one embryo only during IVF and meticulous monitoring of ovarian stimulation.