Multiple Births: Fertility Misconceptions

When couples turn to fertility treatments they're looking to add a child to a loving home – not to make headlines.

The controversy in early 2009 with the birth of octuplets in California has raised concerns regarding practices in fertility and brought into question medical standards that fall outside of established guidelines, such as those set by the American Society of Reproductive Medicine (ASRM), the Canadian Fertility and Andrology Society (CFAS), and the Executive and Council of the Society of Obstetricians and Gynaecologists of Canada (SOGC).

The California Medical Board has since revoked the license of the physician who implanted six embryos into a woman, two of which divided into twins. Dr. Daniel A. Potter, medical director of Huntington Reproductive Center in Southern California, shared his view with the New York Times: "If someone came in and wanted to transfer six embryos in a situation like we're talking about, we have an obligation to protect the patient and not let the patient do things that are unreasonable."

In Canada there are strict CFAS-SOGC guidelines set out for the number of embryos transferred in an IVF (in-vitro fertilization) cycle.

In women under the age of 35, no more than two embryos should be transferred. Women in that same age group who have an excellent prognosis should have one embryo transferred. An excellent prognosis include women going through a first or second cycle of IVF or a cycle immediately after a successful round of IVF, with at least two high-quality embryos available for transfer. A high-quality embryo is an embryo with no or minimal fragments or unevenness.

No more than three embryos should be transferred in women aged 35 to 37. Candidates with high-quality embryos and favourable prognosis can transfer up to two embryos in the first or second round of IVF.

For women aged 38 to 39 years, there should be no more than three embryos transferred in a cycle. Patients with high-quality embryos and favourable prognosis can consider the transfer of two embryos in the first or second round of IVF.

After the age of 39 years, no more than four embryos should be transferred. Women with high-quality embryos should have three embryos transferred, if they're available.

Only in exceptional cases where a woman has had multiple unsuccessful attempts at IVF should transference of more embryos than what's been recommended above be considered.

While general consensus in the past was to implant more embryos to increase the rate of success, recent data has shown that the odds of having a successful pregnancy do not decrease when only two embryos are transferred, which will also reduce the chances of multiple births.

These guidelines clearly outline the goal of Canadian fertility experts – to help patients conceive while avoiding high-risk pregnancies. Your local fertility clinic and the professionals working there strive to ensure that couples have healthy and successful pregnancies. Like you, they know that the gift of a child is truly special. To get the facts, see a fertility specialist in your area.

All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Multiple-Births-Fertility-Misconceptions

Facing a fertility challenge takes courage, and how infertility is treated depends on the cause.

In men, impotence or premature ejaculation can cause infertility. A lack of sperm may also be a factor. When woman experience infertility, physicians will often begin therapy with fertility medications that can regulate or induce ovulation.

Common medications you may be prescribed include:

• clomiphene citrate – this medication induces ovulation in women who have ovulation disorders
• human menopausal gonadotropin (hMG) – women who don't ovulate on their own can get this injected to directly stimulate the ovaries
• follicle-stimulating hormone (FSH) – this medication stimulates the ovaries, resulting in mature egg follicles

Injectable fertility medications can directly increase the risk of multiple births. Oral fertility medications can also increase the risk of multiple births, but generally at a much lower rate.

Surgery is also a viable treatment for infertility in women. Irregularities in the fallopian tubes can often be repaired surgically. If endometriosis is a problem, your physician may treat you with ovulation therapy. In-vitro fertilization (IVF) is also an option if endometriosis is the problem.

Believe it or not, fewer than 5% of infertile couples use IVF as a treatment option. For these patients, IVF can help them realize their dream of raising a cherished child. It involves egg removal, fertilization in a laboratory dish, and transportation back into the uterus.

How successful is IVF? According to recent data from the Canadian Fertility and Andrology Society, the live birth rate per cycle is approximately 30%, depending on the woman’s age.

With a myriad of options, your fertility specialist will guide you to help determine what's best for your family. Before seeing a specialist, people often find it helpful to review the latest information on fertility treatments.

While it takes courage to face fertility challenges, it's also comforting to know you're not alone. Your fertility specialist is equipped to help you every step of the way – committed as you are to a new beginning.

All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Multiple-Births-Fertility-Misconceptions

The world was stunned when the full details of Nadya Suleman's octuplet pregnancy were revealed, making it one of the most popular topics around the water cooler. The physician at the fertility clinic who implanted six embryos in Ms. Suleman did not appear to have followed fertility guidelines set by the American Society of Reproductive Medicine.

In Canada, the Canadian Fertility and Andrology Society (CFAS) and the Society of Obstetricians and Gynaecologists (SOGC) came together to develop joint CFAS-SOGC guidelines for the number of embryos to transfer following IVF (in-vitro fertilization). In general, the recommended number of embryos to be transferred per cycle depends on a number of factors, one of which is age.

There is a higher proportion of multiple births linked to IVF procedures and other fertility treatments than seen with naturally occurring pregnancies. Of the 1,645 deliveries resulting from IVF and intracytoplasmic sperm injection (ICSI) procedures in 2001, 31.5% were multiple births.

Complications surrounding multiple births are also well documented. For example, more than 50% of twins and 90% of triplets are born preterm (before 37 weeks) and have low birth weight, among other potential complications. Compared with single births, twins are born on average five weeks early and triplets seven weeks early. It's also important to keep in mind that being pregnant with multiple births also put the mother at risk of serious complications.

Furthermore, the emotional consequences of multiple births are high. Parents suffer with their children as they face increased birth defects, cognitive development challenges, and childhood hospitalizations and surgeries. The unpublicized side of multiple births also takes a devastating toll on the family as parents cope with the multiplied demands of parenting, extreme fatigue, and 24-hour childcare. Even the strongest of families feel unrelenting stress and pressure, which can escalate into marital discord and severe financial hardships.

In the late 1980s, the Ontario government had stopped funding IVF. Some see this as having been the start of the boom in multiple births in that province as couples resorted to seeking multiple embryo transfers in private settings. At $10,000 per IVF cycle and without financial assistance from the government, couples want to get the most out of their money, knowing that double embryo transfers result in higher live birth rates compared to single embryo transfers.

There may be an answer to the dilemma of multiple births. Studies showed that eSET (elective single embryo transfer) was actually preferred and chosen by patients when they were freed from financial pressure.

Addressing the need for publicly funded IVF, the joint SOGC-CFAS guidelines state that funding of IVF would limit the number of embryos transferred. This reduction would lower health care costs by reducing the number of multiple births and the resulting complications. Several provinces have since changed their stance and now provide public funding for IVF.

A fertility specialist can help you sort through the multiple facts and see how relevant they are for you. Your local fertility clinic will welcome any inquiries you may have.

All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Multiple-Births-Fertility-Misconceptions

A fertility specialist can help you alleviate any concerns you have about multiple births. In general, fertility treatments can increase your risk of multiple births, but there are ways to reduce this risk.

In cases when many eggs are produced in the ovaries, your specialist may recommend freezing surplus embryos. This is especially helpful if you are about to undergo a medical treatment, as it gives you the option of using them in the future.

Some families may welcome the challenges of multiples and see having twins as having an instant family. The choice is personal and best discussed with your fertility specialist.

Should you be in a situation where you're pregnant with multiples, your specialist will work with you and discuss all the available options, including multifetal reductions, which involve reducing the number of viable fetuses.

When considering fertility treatments, being informed is key. Firsthand information can ease many concerns. A fertility specialist will address your questions and offer reassuring scenarios best suited to your family. Click here to find a fertility clinic in your area.

All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Multiple-Births-Fertility-Misconceptions