title: Transvaginal embryo aspiration--a safe method for selective reduction in multiple pregnancies.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel.
authors.forename: J
authors.initials: J
authors.lastname: Itskovitz-Eldor
authors.forename: A
authors.initials: A
authors.lastname: Drugan
authors.forename: J
authors.initials: J
authors.lastname: Levron
authors.forename: I
authors.initials: I
authors.lastname: Thaler
authors.forename: J M
authors.initials: JM
authors.lastname: Brandes
mesh_terms: 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