title: The desire of infertile patients for multiple births.
abstract: OBJECTIVE
  To determine the proportion of infertile women who prefer a multiple birth over a singleton, patient characteristics associated with this desire, and patient knowledge about the risks of multiple births.
  
  
  METHODS
  Prospective analysis.
  
  
  METHODS
  Academic university hospital-based infertility center and private general gynecology clinic.
  
  
  METHODS
  Four hundred sixty-four female patients with infertility who presented for their initial visit.
  
  
  METHODS
  Demographic characteristics, infertility history, desire regarding multiple births, knowledge of the risks of multiple births, and goals of infertility evaluation and treatment were determined by using a 41-question survey. Univariate analysis was performed to assess patient characteristics associated with the desire for multiple births. Independent factors associated with this desire were assessed by multivariable logistic regression analysis.
  
  
  RESULTS
  20.3% of women desired multiples over a singleton gestation. Nulliparity, lower family income, younger patient age, prior evaluation for infertility, longer duration of infertility, and lack of knowledge regarding risks of twin gestations were associated with this desire. Only nulliparity and lower family income were independently associated.
  
  
  CONCLUSIONS
  A sizable minority of infertility patients prefers a multiple birth as their treatment outcome. Patient education may be an effective strategy to reduce the incidence of twin and higher-order multiple pregnancies.
authors.affiliation: Department of Obstetrics and Gynecology, University of Iowa Roy J and Lucille A. Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242-1080, USA.
authors.forename: Ginny L
authors.initials: GL
authors.lastname: Ryan
authors.forename: Sunny H
authors.initials: SH
authors.lastname: Zhang
authors.forename: Anuja
authors.initials: A
authors.lastname: Dokras
authors.forename: Craig H
authors.initials: CH
authors.lastname: Syrop
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Van Voorhis
mesh_terms: D000328:Adult; D005260:Female; D006040:Goals; D006801:Humans; D007182:Income; D007247:Infertility, Female / Q000523:psychology*; D019359:Knowledge; D010298:Parity; D011247:Pregnancy; D011272:Pregnancy, Multiple; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014427:Twins