The desire of infertile patients for multiple births (original) (raw)
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The desire for multiple pregnancy in male and female infertility patients
Human Reproduction, 2004
BACKGROUND: It is apparent that many fertility patients consider multiple birth an ideal treatment outcome. We wished to evaluate the desire for multiple birth among patients, and the effect of patient demographics and recognition of the increased fetal risks of multiple pregnancy on this desire. METHODS: This was a prospective questionnaire study completed by 801 male and female infertility patients attending a tertiary level Canadian university fertility clinic. Two logistic regression analyses were performed with desire for multiple birth with next fertility treatment and recognition of the increased fetal risks of multiple pregnancy as the dependent variables. RESULTS: 41% of patients desired a multiple birth. Increasing duration of infertility or previous assisted reproductive treatment increased, and having previous children or recognition of the increased fetal risks decreased, this desire. Patient age or sex did not affect desire for multiple birth. Previous assisted reproductive treatment was associated with increased recognition of the fetal risks of multiple pregnancy. CONCLUSIONS: A signi®cant proportion of fertility patients considers multiple birth an ideal treatment outcome. Recognition of the increased fetal risks of multiple pregnancy signi®cantly reduced this desire. Patient education may play an important role in assisting physicians in the quest to reduce the contribution of assisted reproductive treatment to multiple births and their attending complications.
The Desire for Multiple Pregnancy among Patients with Infertility and Their Partners
Objective. To study the predictors for desire for multiple pregnancies and the influence of providing information regarding the maternal and fetal complications associated with multiple pregnancies on their preference for multiple pregnancies. Methods. Couples attending an infertility clinic were offered to fill up a questionnaire separately. Following this, they were handed a pamphlet with information regarding the risks associated with multiple pregnancies. The patients will then be required to answer the question on the number of pregnancies desired again. Results. Two hundred fifty three out of 300 respondents completed the questionnaires adequately. A higher proportion of respondents, 60.3% of females and 57.9% of males, prefer singleton pregnancy. Patients who are younger than 35 years, with preexisting knowledge of risks associated with multiple pregnancies and previous treatment for infertility, have decreased desire for multiple pregnancies. However, for patients who are older than 35, with longer duration of infertility, and those patients who have preexisting knowledge of the increased risk, providing further information regarding the risks did not change their initial preferences. Conclusion. Providing and reinforcing knowledge on the risks to mother and fetus associated with multiple pregnancies did not decrease the preference for multiple pregnancies in patients.
Infertility patients and their partners differences in the desire for twin gestations
Obstetrics & Gynecology, 2003
To explore how the individuals within an infertile couple differ from one another in their attitudes toward the conception of twin gestations. METHODS: From November 1999 through February 2000, consecutive couples undergoing treatment at a universitybased infertility clinic were invited to participate in a faceto-face interview that ascertained their individual desires for singleton and twin gestations and their perception of the risks associated with these pregnancies. RESULTS: Of the 94 couples approached, 90 (96%) agreed to participate in the study. Patients estimated the incidence of prematurity, low birth weight, preeclampsia, and postpartum depression in twin gestations to be significantly greater than their partners did (27% versus 17%, 26% versus 17%, 22% versus 16%, and 21% versus 16%, respectively). Despite these higher estimates, the desire for a twin gestation was similar. In 19 couples (21%), the patient and partner did not agree whether a singleton or twin pregnancy was the most preferred outcome. No predictive factor for this discordance could be identified. CONCLUSION: Women undergoing infertility treatment are less risk averse than their partners. Additionally, a sizeable portion of couples do not align in their preference for a twin gestation. These differences should be recognized and addressed during the preconceptional period.
Trends in multiple deliveries and infertility treatments in France
BJOG: An International Journal of Obstetrics and Gynaecology, 1993
Objective To point out the association between infertility treatments and the increasing number of multiple Design Comparison over time of the incidence of multiple deliveries, the proportion of deliveries resulting Data Use of existing statistics: vital statistics, surveys of AC centres and ovulation inductor sales.
Patient perspectives on IVF success and likelihood of multiple gestations
Fertility and Sterility, 2015
Objective: To describe couples' perceptions of fertility treatment success rates and chance of multiples. Design: Longitudinal, prospective, mixed methods study. Methods Who: 34 couples (2 same-sex female) who presented for care with a reproductive endocrinologist and infertility specialist (REI) at an academic medical center.
Rising multiple maternity rates and medical management of subfertility: Better information is needed
The European Journal of Public Health, 2003
Multiple maternity rates rose rapidly from the mid-1970s onwards in many Western countries. This has major public heath implications, as multiple pregnancies can lead to many problems for the mothers and their children. Ovarian stimulation and assisted reproductive technology (ART) play a major role in these trends but there are few data about them. Consistently defined multiple maternity rates, including twin and triplet maternity rates are needed annually for each country in order to monitor time trends and make international comparisons. In order to assess the contribution of ovarian stimulation and ART to trends in multiple maternities and to monitor their impact on pregnancy outcome, fuller and more consistent data are needed. These could be collected from ART centres and other care providers, or through medical birth registries or national surveys.
BJOG: An International Journal of Obstetrics and Gynaecology, 1992
Objective To assess prospectively the number of triplet and higher multiple births born in 1989 and their methods of conception. To assess obstetric factors and the effect of these pregnancies on neonatal medical services. Design All consultant paediatricians received a monthly card asking whether they had been involved in the management of triplet and higher multiple pregnancies delivered after 22 weeks gestation. Detailed questionnaire sent to those giving a positive response. Setting British Paediatric Surveillance Unit organized mailings to all members of the British Paediatric Association working in the British Isles. Subjects 156 pregnancies resulting in 482 babies (143 triplets, 12 quadruplets and 1 quintuplet set). These data were compared to nationally collected OPCS data. Main outcome measures Method of conception, obstetric performance, neonatal outcome. Results Of the 156 pregnancies, 47 (31%) were conceived naturally, 52 (34%) had ovarian stimulation (usually with clomiphene or gonadotrophins) 37 (24%) had IVF and 17 (1 1 %) GIFT. All quadruplet and quintuplet pregnancies were established after assisted reproduction. Mothers who had had IVF were significantly older than those who had ovulation induction alone. The median gestation at birth was 33 weeks. Overall 18 1 (40%) of the babies required intensive care for a median duration of 5 days. The perinatal mortality of the triplets alone and quads and quins together was 70 and 104 per 1000 respectively. Conclusions Assisted reproduction is the major cause of triplets and higher multiple births and ovarian stimulation is the single most important technique currently in use. These babies are very likely to be born pre term and make considerable demands on neonatal intensive care facilities.
Psychosocial risks associated with multiple births resulting from assisted reproduction
Fertility and Sterility, 2005
Objective: To determine if increased psychosocial risks are associated with each increase in birth multiplicity (i.e., singleton, twin, triplet) resulting from assisted reproduction. Design: Stratified random sample (n ϭ 249). Setting: An academic teaching hospital and private practice infertility center. Patient(s): Mothers raising 1-to 4-year-old children (n ϭ 128 singletons, n ϭ 111 twins, and n ϭ 10 triplets) conceived through assisted reproduction. Intervention(s): Self-administered, mailed survey. Main Outcome Measure(s): Scales measuring material needs, quality of life, social stigma, depression, stress, and marital satisfaction. Result(s): Using multivariate logistic regression models, for each additional multiple birth child, the odds of having difficulty meeting basic material needs more than tripled and the odds of lower quality of life and increased social stigma more than doubled. Each increase in multiplicity was also associated with increased risks of maternal depression.
Fertility and Sterility, 2009
Objective: To determine the psychosocial risks associated with multiple births (twins or triplets) resulting from assisted reproductive technology (ART). Design: Transverse study. Setting: Infertility units of a university hospital and a private hospital. Patient(s): Mothers and fathers of children between 6 months and 4 years conceived by ART (n ¼ 123). The sample was divided into three groups: parents of singletons (n ¼ 77), twins (n ¼ 37), and triplets (n ¼ 9). Intervention(s): The questionnaire was self-administered by patients. It was either completed at the hospital or mailed to participants' homes. Main Outcome Measure(s): Scales measured material needs, quality of life, social stigma, depression, stress, and marital satisfaction. Result(s): Logistic regression models were applied. Significant odds ratios were obtained for the number of children, material needs, social stigma, quality of life, and marital satisfaction. The results were more significant for data provided by mothers than by fathers. Conclusion(s): The informed consent form handed out at the beginning of ART should include information on the high risk of conceiving twins and triplets and on the possible psychosocial consequences of multiple births. As soon as a multiple pregnancy is confirmed, it would be useful to provide information on support groups and institutions. Psychological advice should also be given to the parents.