April 5th, 2020

Blastocyst Transfer in Human in Vitro Fertilization: A Solution to the Multiple Pregnancy Epidemic
Authors:  William F. Rayburn, M.D.
  Predictable and reproducible pregnancy rates following in vitro fertilization (IVF) have revolutionized infertility treatment. This practice of attempting fertilization of all the ova collected after inducing superovulation and then depositing in utero more than one embryo, when available, has
introduced concern about the iatrogenic multiple pregnancy "epidemic." Most couples consider the possibility of twins desirable, but higher-order multiple births are typically rejected because of risks and costs. Most of the additional costs of a singleton or twins are attributed to IVF, whereas most expenses with any surviving triplets or more are due to neonatal intensive care. At this writing, I had just delivered triplets in the presence of advanced cervical dilation at 23 weeks' gestation. None of these normal-appearing fetuses survived because of extreme immaturity.
Keywords:  blastocyst transfer; fertilization in vitro; infertility, female; pregnancy, multiple
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