Transvaginal embryo aspiration--a safe method for selective reduction in multiple pregnancies.
OBJECTIVE
To evaluate pregnancy outcome after transvaginal selective embryo aspiration and to compare the results with those reported previously with other techniques for selective abortion.


METHODS
Retrospective case series.


METHODS
University-based in vitro fertilization (IVF) program.


METHODS
Nineteen women with multiple pregnancy who conceived after ovulation induction or IVF/gamete intrafallopian transfer.


METHODS
Transvaginal ultrasound-guided aspiration of the embryo(s) was performed at 7 to 8 weeks of gestation.


METHODS
Early and late complications related to the procedure, outcome of pregnancy, and birth weight.


RESULTS
In 18 cases, the initial number of embryos (3 to 7) was reduced to two. In 1 case, the number of embryos was reduced from 4 to 3. None of the remaining fetuses vanished after the procedure. One patient delivered at 25 weeks and all other patients delivered healthy, viable infants (a pregnancy loss rate of 5.3%).


CONCLUSIONS
Transvaginal embryo aspiration in early gestation appears to be a simple and relatively safe procedure for selective termination in patients with high-order multiple pregnancy. The cumulative loss rate of selective termination procedures previously reported by others is three times higher than the loss encountered in our series. This earlier procedure may be more acceptable to patients from emotional and religious points of view.
Itskovitz-Eldor
J
J
Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel.
Drugan
A
A
Levron
J
J
Thaler
I
I
Brandes
J M
JM
D000028:Abortion, Induced / Q000379:methods*; D005260:Female; D005307:Fertilization in Vitro; D015181:Gamete Intrafallopian Transfer; D005865:Gestational Age; D006801:Humans; D010062:Ovulation Induction; D011247:Pregnancy; D011272:Pregnancy, Multiple; D013396:Suction; D014621:Vagina