Less is more: the risks of multiple births

Elster, Nanette

doi:10.1016/s0015-0282(00)00713-5

Cited by 125 publications

(49 citation statements)

References 10 publications

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“…A twin pregnancy is an adverse outcome of an IVF cycle, because of the increased risk for medical complications including prenatal and neonatal mortality and morbidity, preterm delivery, low birthweight and long-term medical and developmental problems (ESHRE Capri Workshop, 2000;Elster, 2000;Olivennes, 2000;Land and Evers, 2003). As a result, the medical costs of a twin pregnancy increase dramatically compared to the costs for a singleton pregnancy (Elster, 2000;Kinzler et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Early cleavage is a valuable addition to existing embryo selection parameters: a study using single embryo transfers

Montfoort¹

2004

Human Reproduction

156

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BACKGROUND: To reduce the twin pregnancy rate, elective single embryo transfer (eSET) is increasingly implemented. Improvement of the results obtained with eSET can be achieved by better selection of the most viable embryo. This study investigated the predictive value of early cleavage (EC) as an additional parameter for selecting the embryo with the highest implantation potential by using data from SET's. METHODS: Data from 165 SET's were retrospectively evaluated. Cleavage to the 2-cell stage was determined 23 -26 h after injection or 25 -28 h after insemination. Selection of the embryo to be transferred was based on cell morphology and cell number on the day of transfer, not on the EC status. Additional information on the predictive value of EC on developmental potential was obtained by analysing 253 transfers with two embryos (double embryo transfer, DET) and blastocyst formation of 1160 surplus embryos. Logistic regression was used to determine the predictors of pregnancy or blastocyst development. RESULTS: A significantly higher pregnancy rate was observed after transfer of single EC embryos compared to single non-EC embryos (46 versus 18%). This result was confirmed by the significantly higher pregnancy rate after DET with two EC embryos as compared to DET with two non-EC embryos (45 versus 25%) and the blastocyst formation of EC embryos compared to non-EC embryos (66 versus 40%). Logistic regression showed that EC is an independent predictor for both pregnancy and blastocyst development in addition to cell morphology and cell number. CONCLUSIONS: In order to improve the selection of the embryo with the highest implantation potential, selection for transfer should not be based on cell number and morphology on the day of transfer alone, but also on early cleavage status.

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Section: Introductionmentioning

confidence: 99%

Early cleavage is a valuable addition to existing embryo selection parameters: a study using single embryo transfers

Montfoort¹

2004

Human Reproduction

156

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“…According to data from the US ART Surveillance System, 49% of 2006 ART births were multiple gestation births compared with only 3% multiple gestation for all US births (2,7). Infants born as multiples have an increased risk of preterm delivery, low birthweight, infant mortality, and longterm disability (8)(9)(10).…”

mentioning

confidence: 99%

Birth outcomes of intended pregnancies among women who used assisted reproductive technology, ovulation stimulation, or no treatment

D’Angelo

Whitehead

Helms

et al. 2011

Fertility and Sterility

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“…In some cases, the infants may be spared from these afflictions (e.g., the Gosselin and Masche sextuplets are all healthy), but more often than not, serious complications ensue. Approximately 78% of higherorder multiples require prolonged care in the Neonatal Intensive Care Unit, compared to 48% of twins and 15% of singletons [6].…”

Section: The Medical Social and Emotional Consequences Of Hombsmentioning

confidence: 99%

“…Robertson is surely correct that all persons have a legal right to procreative autonomy, and this has been supported in multiple state and Supreme Court cases. 6 Moreover, although the nonidentity problem has its share of supporters and detractors, it is admittedly difficult to point to a clear consequentialist reason for maintaining that the resulting children of HOMBs have been harmed, even if they are born with certain defects, if the only alternative to being born as a multiple was not being born at all.…”

Section: An Analysis Of Suleman's Actionsmentioning

confidence: 99%

Parental, Medical, and Sociological Responsibilities: “Octomom” as a Case Study in the Ethics of Fertility Treatments

Manninen¹

2011

J Clinic Res Bioeth

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Less is more: the risks of multiple births

Cited by 125 publications

References 10 publications

Early cleavage is a valuable addition to existing embryo selection parameters: a study using single embryo transfers

Early cleavage is a valuable addition to existing embryo selection parameters: a study using single embryo transfers

Birth outcomes of intended pregnancies among women who used assisted reproductive technology, ovulation stimulation, or no treatment

Parental, Medical, and Sociological Responsibilities: “Octomom” as a Case Study in the Ethics of Fertility Treatments

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