What is the most relevant standard of success in assisted reproduction? The importance of informed choice.

Whilst there is a need to emphasize the birth rates of healthy infants when reporting success rates following infertility treatment, is 'the singleton term gestation per cycle started' the most appropriate measure? Although there are many ways to measure the efficacy of medical intervention, none of these exclude from the 'successes' those in whom complications have occurred. The safe delivery of healthy twins at term, while possibly not the ideal outcome, should still be regarded as a treatment success. Although multiple pregnancy, in particular high order multiple pregnancy, continues to be a major problem associated with assisted reproductive treatments and also with ovulation induction, appropriate counselling concerning the risks of twin and triplet pregnancies will allow couples to make informed choices and allow clinicians to continue to individualize treatment plans.