title: Limiting multiple pregnancy in in vitro fertilization/embryo transfer (IVF-ET) cycles.
abstract: OBJECTIVE
  Our purpose was to assess how the number of embryos transferred can be adjusted to limit multiple gestations.
  
  
  METHODS
  A retrospective analysis of 535 consecutive embryo transfers for the years 1991-1993 was conducted.
  
  
  RESULTS
  Fewer than three embryos were associated with a low pregnancy rate. Pregnancy rates were highest in women less than 35 when four or more embryos were transferred. With four or more embryos, multiple gestation pregnancy correlated with the number of high-quality embryos transferred. The risk of triplets and quadruplets was greatest for women less than 40.
  
  
  CONCLUSIONS
  Multiple-embryo transfer carries a risk of plural gestation. The risk of multiple pregnancy cannot be eliminated without decreasing the pregnancy rate. The risk of high-order multiple pregnancy was best correlated with the number of good-quality embryos transferred. While all are at risk, patients younger than 40 were at highest risk.
authors.affiliation: Department of Obstetrics and Gynecology, University MacDonald Womens Hospital, Cleveland, Ohio, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Austin
authors.forename: S P
authors.initials: SP
authors.lastname: Stewart
authors.forename: J M
authors.initials: JM
authors.lastname: Goldfarb
authors.forename: L A
authors.initials: LA
authors.lastname: Sheean
authors.forename: V R
authors.initials: VR
authors.lastname: Gindlesperger
authors.forename: M A
authors.initials: MA
authors.lastname: Duchon
mesh_terms: D000328:Adult; D004624:Embryo Transfer / Q000379:methods*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D011247:Pregnancy; D018873:Pregnancy Rate; D011272:Pregnancy, Multiple; D012189:Retrospective Studies