Comparative study of the psychosocial risks associated with families with multiple births resulting from assisted reproductive technology (ART) and without ART

Bes, Montserrat Roca-de; Gutiérrez‐Maldonado, José; Gris-Martínez, José M.

doi:10.1016/j.fertnstert.2011.05.007

Cited by 17 publications

(20 citation statements)

References 37 publications

(45 reference statements)

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“…Twenty articles compared mental health outcomes in the antenatal, postpartum, and early parenthood period in parents of multiples versus parents of singletons (Choi et al 2009; Clarke et al 2014; Eisengart et al 2003; Ellison et al 2005; Feldman et al 2004; Forman et al 2000; Freeman et al 2007; Glazebrook et al 2001, 2004; Haigh and Wilkinson 1989; Hay et al 1990; Jahangiri et al 2011; Olivennes et al 2005; Roca-de Bes et al 2011; Sheard et al 2007; Singer et al 1999; Thorpe et al 1991, 1995; Vilska et al 2009; Zanardo et al 1998). We summarize this literature by subtopic below (e.g., classes of symptoms, time-point, and maternal outcomes versus paternal outcomes).…”

Section: Resultsmentioning

confidence: 99%

“…We identified nine published studies that examined the mental health of partners in the case of multiple gestation pregnancies or births, and all of these focused on fathers (Baor et al 2004; Colpin et al 1999; Cook et al 1998; Feldman et al 2004; Glazebrook et al 2001; Munro et al 1990; Roca-deBes et al 2011; Vilska et al 2009; Zanardo et al 1998). Of note, some studies did not compare outcomes in the case of multiples versus singletons (Baor et al 2004; Colpin et al 1999; Cook et al 1998;Munro et al 1990) and one study pooled mothers’ and fathers’ data, thus precluding specific conclusions about paternal mental health (Roca-de Bes et al 2011).…”

Section: Resultsmentioning

confidence: 99%

“…Of note, some studies did not compare outcomes in the case of multiples versus singletons (Baor et al 2004; Colpin et al 1999; Cook et al 1998;Munro et al 1990) and one study pooled mothers’ and fathers’ data, thus precluding specific conclusions about paternal mental health (Roca-de Bes et al 2011). Broadly speaking, most research suggests similar patterns in mental health outcomes for mothers and fathers of multiples at most time-points (e.g., Vilska et al 2009).…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Raising multiples: mental health of mothers and fathers in early parenthood

Wenze

Battle

Tezanos

2014

Arch Womens Ment Health

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The rate of twin and higher-order gestation births has risen dramatically in recent decades in the United States as well as other Western countries. Although the obstetrical and neonatal risks of multiple gestation pregnancies are well-documented, much less is known regarding the mental health impact on parents of multiples during the perinatal and early parenthood period. Given that parents of multiples face greater functional demands, as well as other pressures (financial, medical) this population may be at risk for heightened distress. We conducted a systematic review of quantitative, English language studies that assessed mental health outcomes of parents of multiples during pregnancy, in the first postpartum year, and in the period of early parenthood, including depression, anxiety, stress, and related constructs. Twenty-seven articles published between 1989 and 2014 met selection criteria and were included in the review. Studies utilized a wide range of methods and outcome constructs, often making comparisons difficult. Although some studies found no differences, most investigations that compared mental health outcomes in parents of multiples versus parents of singletons found that parents of multiples experience heightened symptoms of depression, anxiety, and parenting stress. We discuss gaps in the existing body of literature on parental mental health related to multiple gestation birth and conclude by discussing the need for novel intervention strategies to meet the needs of this growing population. Parents of multiples may experience worse mental health outcomes than parents of singletons. More research is needed, and future work should explore potential treatment and support options.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Raising multiples: mental health of mothers and fathers in early parenthood

Wenze

Battle

Tezanos

2014

Arch Womens Ment Health

View full text Add to dashboard Cite

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“…Investigators felt nurse counseling was important because nurses provided more individualized support for their patient’s particular physical, emotional, and social situation [38]. Nurses, in particular, can provide patients with tools to cope with the emotional burden of multiple ART cycles [42]. Approximately 70 % of patients also appreciated a follow-up phone call just prior to oocyte retrieval to discuss any relevant questions that might have arisen during IVF treatment.…”

Section: Introductionmentioning

confidence: 99%

Promoting the use of elective single embryo transfer in clinical practice

Tobias

Sharara

Franasiak

et al. 2016

Fertil Res and Pract

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BackgroundThe transfer of multiple embryos after in vitro fertilization (IVF) increases the risk of twins and higher-order births. Multiple births are associated with significant health risks and maternal and neonatal complications, as well as physical, emotional, and financial stresses that can strain families and increase the incidence of depression and anxiety disorders in parents. Elective single embryo transfer (eSET) is among the most effective methods to reduce the risk of multiple births with IVF.Main bodyCurrent societal guidelines recommend eSET for patients <35 years of age with a good prognosis, yet even this approach is not widely applied. Many patients and clinicians have been reluctant to adopt eSET due to studies reporting higher live birth rates with the transfer of two or more embryos rather than eSET. Additional barriers to eSET include risk of treatment dropout after embryo transfer failure, patient preference for twins, a lack of knowledge about the risks and complications associated with multiple births, and the high costs of multiple IVF cycles. This review provides a comprehensive summary of strategies to increase the rate of eSET, including personalized counseling, access to educational information regarding the risks of multiple pregnancies and births, financial incentives, and tools to help predict the chances of IVF success. The use of comprehensive chromosomal screening to improve embryo selection has been shown to improve eSET outcomes and may increase acceptance of eSET.ConclusionseSET is an effective method for reducing multiple pregnancies resulting from IVF. Although several factors may impede the adoption of eSET, there are a number of strategies and tools that may encourage the more widespread adoption of eSET in clinical practice.

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“…From the new parents ' perspective, the rearing of multiple babies is associated with practical and emotional diffi culties (Garel et al 1997;Roca-de Bes et al 2011). A 2002 analysis showed the total direct cost to the National Health Service (NHS) per IVF twin ( £ 9,122) was three times higher than an IVF singleton ( £ 3,313), whereas IVF triplet costs ( £ 32,354) were 10 times higher (Ledger et al 2006 Transferring only one embryo results in a decrease in pregnancy rates per cycle started (van Montfoort et al 2006).…”

Section: Introductionmentioning

confidence: 99%

When no choice of embryos exists, the multiple pregnancy risk is still high

Wong

Emerson

Mocanu

2012

Journal of Obstetrics and Gynaecology

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Multiple pregnancies arising from assisted reproduction are known to be associated with increased medical, psychological, economical and social risks. If only two embryos develop after culture, how should the couple be counselled in relation to the risk of multiple pregnancy? We performed a retrospective review of all IVF/ICSI treatments performed between 1 January 2005 and 31 December 2007, that resulted in double embryos transfer (DET). We identified 623 cycles with a fortuitous DET (Group I) and 635 cycles with an elective DET (Group II). Group II were significantly more likely to have twins when compared with Group I, irrespective of age. Twin rates in Group I were higher in IVF compared with ICSI; 33.3% vs 16.6% in < 35 years old and 16.2% vs 7.6% in 35-40 years old. Therefore, single embryo transfer should be considered for IVF patients below 35 years old, even if only two good quality embryos are available.

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Comparative study of the psychosocial risks associated with families with multiple births resulting from assisted reproductive technology (ART) and without ART

Cited by 17 publications

References 37 publications

Raising multiples: mental health of mothers and fathers in early parenthood

Raising multiples: mental health of mothers and fathers in early parenthood

Promoting the use of elective single embryo transfer in clinical practice

When no choice of embryos exists, the multiple pregnancy risk is still high

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