title: Impact of assisted reproductive technology on the incidence of multiple-gestation infants: a population perspective.
abstract: OBJECTIVE
  To study the value of a population view in assessing assisted reproductive technology (ART) multiple-gestation infants.
  
  
  METHODS
  Descriptive comparison of ART treatment and population statistics in seven developed countries (United States [U.S.], South Korea, United Kingdom, the Netherlands, Australia, Belgium, Denmark) with varying ART utilization and single-embryo transfer (SET) rates.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  None.
  
  
  METHODS
  The contribution of ART multiple-gestation infants to the total number of multiple-gestation infants in a population was calculated in relation to utilization of ART and SET rates.
  
  
  RESULTS
  The number of ART treatments leading to embryo transfer varied from 304 per million inhabitants in the U.S. to 1,518 in Denmark. The percentage of ART cycles that utilized SET varied from 8.8% in South Korea to 53.3% in Australia. Reflecting both utilization rates and SET rates, the percentage of multiple-gestation infants in the population attributed to ART ranged from 14.7% in South Korea to 29.0% in Denmark.
  
  
  CONCLUSIONS
  In seven countries, the contribution of ART multiple-gestation infants to all multiple-gestation infants varies from 14.7% to 29.0%, a percentage that was influenced by both the SET rate per cycle and ART utilization rates. In the monitoring of safety and efficacy of fertility treatment, registration of the percentage of SET cycles alone might not be sufficient.
authors.affiliation: Center for Reproductive Medicine, Academic Medical Center, Amsterdam, the Netherlands. Electronic address: i.scholten@amc.uva.nl.
authors.forename: Irma
authors.initials: I
authors.lastname: Scholten
authors.affiliation: National Perinatal Epidemiology and Statistics Unit, School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Georgina M
authors.initials: GM
authors.lastname: Chambers
authors.affiliation: Center for Reproductive Medicine, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Laura
authors.initials: L
authors.lastname: van Loendersloot
authors.affiliation: Center for Reproductive Medicine, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Fulco
authors.initials: F
authors.lastname: van der Veen
authors.affiliation: Center for Reproductive Medicine, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Sjoerd
authors.initials: S
authors.lastname: Repping
authors.affiliation: Department of Obstetrics and Gynecology, Kennemer Gasthuis, Haarlem, the Netherlands.
authors.forename: Judith
authors.initials: J
authors.lastname: Gianotten
authors.affiliation: Center for Reproductive Medicine, Vrije Universiteit Medical Center, Amsterdam, the Netherlands.
authors.forename: Peter G A
authors.initials: PG
authors.lastname: Hompes
authors.affiliation: Department of Obstetrics and Gynaecology, School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: William
authors.initials: W
authors.lastname: Ledger
authors.affiliation: Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Ben W J
authors.initials: BW
authors.lastname: Mol
mesh_terms: D000293:Adolescent; D005060:Europe / Q000453:epidemiology; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D011157:Population Dynamics; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data*; D056910:Republic of Korea / Q000453:epidemiology; D056826:Single Embryo Transfer / Q000706:statistics & numerical data*; D020554:Sperm Injections, Intracytoplasmic / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
keywords: Single-embryo transfer; assisted reproductive technology; multiple pregnancies; outcome measure