Update on selective reduction.
Over the past 25 years fetal reduction has been utilized to reduce the risks of higher-order multiple pregnancies that have resulted from overly successful infertility therapies. The demographics of multiple pregnancy patients have evolved over the past decade, with increasing proportions coming from IVF as opposed to ovulation induction, being older and a higher proportion with donor eggs. Genetic diagnosis prior to reduction is becoming more common and is very safe in experienced hands. For all starting numbers, including twins, reduction to a lower number of fetuses reduces fetal losses, prematurity, and infant mortality and morbidity.
Evans
Mark I
MI
Comprehensive Genetics, Mt. Sinai School of Medicine, New York, NY 10021, USA. evans@compregen.com
Ciorica
Doina
D
Britt
David W
DW
Fletcher
John C
JC
D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D018607:Pregnancy Reduction, Multifetal / Q000941:ethics / Q000639:trends; D014427:Twins; D014481:United States