title: The incidence of multiple gestations after in vitro fertilization is dependent on the number of embryos transferred and maternal age.
abstract: OBJECTIVE
  To determine if the incidence of multiple gestations after IVF differs significantly depending on the number of embryos transferred and maternal age.
  
  
  METHODS
  Retrospective analysis of IVF database.
  
  
  METHODS
  Tertiary care academic center.
  
  
  METHODS
  One thousand eight hundred sixty-seven patients undergoing IVF with up to four embryos transferred during 1986 through 1993.
  
  
  METHODS
  The rate of singleton and multiple gestations > 20 weeks estimated gestational age (EGA).
  
  
  RESULTS
  The incidence of triplet gestations > 20 weeks EGA among patients < or = 34 years of age with three versus four embryos transferred was 0.3% (1/335) versus 2.4% (15/662), respectively. The incidence of twin gestations > 20 weeks EGA among patients < or = 34 years of age with two versus four embryos transferred was 1.3% (3/234) versus 7.4% (46/622), respectively. Also among patients < or = 34 years of age, the incidence of singleton gestations > 20 weeks EGA with two versus three embryos transferred was 12.8% (30/234) versus 15.8% (53/335); with two versus four embryos was 12.8% (30/234) versus 17.2% (107/622); and with three versus four embryos was 15.8% (53/335) versus 17.2% (107/622), respectively.
  
  
  CONCLUSIONS
  In women < or = 34 years of age undergoing IVF-ET, the transfer of four versus three and four versus two embryos significantly increased the incidence of triplet and twin gestations, respectively, without significantly improving the chance of singleton conception. This implies that a policy of transferring only three embryos should be considered in this age group (realizing that such a policy may merit modulation if pretransfer embryo selection is used.).
authors.affiliation: Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk 23507, USA.
authors.forename: T O
authors.initials: TO
authors.lastname: Svendsen
authors.forename: D
authors.initials: D
authors.lastname: Jones
authors.forename: L
authors.initials: L
authors.lastname: Butler
authors.forename: S J
authors.initials: SJ
authors.lastname: Muasher
mesh_terms: D000328:Adult; D004624:Embryo Transfer / Q000379:methods*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007256:Information Systems; D008423:Maternal Age; D011247:Pregnancy; D011272:Pregnancy, Multiple; D012189:Retrospective Studies