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Ob/Gyn Group Urges Docs to Help Prevent 'Octomom'-Type Multiple Births
Date:1/25/2013

multiples include in vitro fertilization (IVF), in which fertilized eggs are placed into a woman's uterus, and use of a medication called clomiphene (brand names Clomid and Serophene) that stimulates the ovaries to release eggs.

"I think many IVF programs are quite good at [discussing risks with women]," said Dr. Lori Day, a maternal-fetal medicine specialist at the University of Michigan in Ann Arbor, who was not involved in writing the new recommendations. "I don't know if women hear as much about risk with pill medications."

Among the pregnancies resulting from IVF in 2010, 26 percent were twins. The rate of triplets and higher multiples from IVF has dropped from 6 percent in 2003 to 1.3 percent in 2010, thanks to advances that help clinicians select viable embryos more precisely and thus reduce the number of implanted embryos, according to the ACOG report.

In cases where women are already pregnant with triplets or higher multiples, "we are obligated to give the woman as much information as she needs or wants, and it is her decision whether she reduces or carries the pregnancy," Spillman said.

Multi-fetal pregnancy reduction is a type of selective abortion in the first trimester or early second trimester to reduce the number of fetuses, in most cases to two.

Reduction is distinct from abortions that are done to end a pregnancy altogether, and in some cases can improve the likelihood that the other fetuses will survive, Day noted.

The new recommendations, which were published in the February issue of the journal Obstetrics & Gynecology, echo the ACOG's 2007 recommendations, but they include more data on the risks of multi-fetal pregnancy.

Still, the decision to carry through with a multi-fetal pregnancy is ultimately up to the mother, the experts said. "These recommendations make it more clear that the woman's autonomy is what guides the decision process," Spillman noted.

Multi-fetal pregnancies put women
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Ob/Gyn Group Urges Docs to Help Prevent 'Octomom'-Type Multiple Births
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