Guidelines to Decrease Odds of Multiple Births Praised by March of Dimes

WHITE PLAINS, N.Y., APRIL 15, 2004 – The March of Dimes today praised efforts by the medical profession in the United States to reduce the number of triplets and higher order multiple births resulting from in vitro fertilization (IVF) procedures.

A study published today in The New England Journal of Medicine found that the percentage of IVF-related pregnancies with triplets or more decreased by nearly one-third between 1997 and 2000.  The decrease followed the 1998 publication of guidelines by the American Society for Reproductive Medicine urging fertility specialists to limit the number of embryos transferred during the procedure.

“Multiple pregnancies -- twins, triplets and higher -- are a major risk factor for premature birth, which is a serious and costly problem in the United States,” says Nancy S. Green, M.D., medical director of the March of Dimes.  Dr. Green says that the number of multiple births in the United States jumped dramatically over the past two decades.  Between 1980 and 2000, the number of twin births increased 74 percent, and the number of higher order multiples (triplets or more) increased fivefold.  In 2002, the latest year for which data are available, 3.3 percent of babies in this country were born in sets of two, three or more.

Preterm babies are at increased risk of serious health complications or death in the newborn period as well as lasting disabilities, such as mental retardation, cerebral palsy, blindness, and hearing loss. While advances in caring for very small infants has brightened the outlook for these babies, the chances remain slim that all infants in a set of higher order multiples will survive without some long term effects, Dr. Green says.  In addition, women who are pregnant with multiples face an increased risk of complications such as high blood pressure (preeclampsia) and gestational diabetes.

Dr. Green cautions that today's NEJM study did not examine trends relating to the use of ovulation-inducing hormones and other drugs.  She says the use of these drugs carries serious risks and concerns similar to the use of IVF and other assisted reproductive technologies.

“Trends in Embryo-Transfer Practice and in Outcomes of the Use of Assisted Reproductive Technology in the United States,” by Tarun Jain, M.D., and colleagues, appeared in NEJM, volume 350, number 16, April 15, 2004.