OBJECTIVE: To estimate the cumulative probability of liveborn multiples after IVF to improve patient counseling regarding this significant morbidity. DESIGN: Retrospective cohort study. SETTING: Large academic-affiliated infertility practice. PATIENT(S): A total of 10,169 women were followed from their first fresh, nondonor IVF cycle through up to six fresh and frozen IVF cycles from 2000-2010. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Delivery of a liveborn infant(s). RESULT(S): After three IVF cycles the cumulative live birth rate (CLBR) was 53.2%. The singleton, twin, and triplet CLBRs were 38.0%, 14.5%, and 0.7%. After six IVF cycles the CLBR was 73.8%, with 52.8%, 19.8%, 1.3% for singletons, twins, and triplets. Of the 5,433 live births, 71.4% were singletons, 27.1% were twins, and 1.5% were triplets. Women more than 39 years had the lowest incidence of liveborn multiples with CLBRs of 5.2% after three cycles and 9.5% after six cycles. The twin CLBR doubled from cycles 1 through 3 with the rate of increase slowing from cycles 3 through 6. Although very low in absolute terms, the triplet CLBR also doubled from cycles 1 through 3 and doubled again from cycles 3 through 6. Of the 1,970 pregnancies that began as multifetal on ultrasound, 77.4% resulted in liveborn multiples. CONCLUSION(S): Providers should be aware of the cumulative probability of liveborn multiples to effectively counsel patients on this important issue. With nearly three-quarters of all women having live birth after up to six IVF cycles, it is encouraging to report a low incidence of liveborn multiples.
OBJECTIVE: To estimate the cumulative probability of liveborn multiples after IVF to improve patient counseling regarding this significant morbidity. DESIGN: Retrospective cohort study. SETTING: Large academic-affiliated infertility practice. PATIENT(S): A total of 10,169 women were followed from their first fresh, nondonor IVF cycle through up to six fresh and frozen IVF cycles from 2000-2010. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Delivery of a liveborn infant(s). RESULT(S): After three IVF cycles the cumulative live birth rate (CLBR) was 53.2%. The singleton, twin, and triplet CLBRs were 38.0%, 14.5%, and 0.7%. After six IVF cycles the CLBR was 73.8%, with 52.8%, 19.8%, 1.3% for singletons, twins, and triplets. Of the 5,433 live births, 71.4% were singletons, 27.1% were twins, and 1.5% were triplets. Women more than 39 years had the lowest incidence of liveborn multiples with CLBRs of 5.2% after three cycles and 9.5% after six cycles. The twin CLBR doubled from cycles 1 through 3 with the rate of increase slowing from cycles 3 through 6. Although very low in absolute terms, the triplet CLBR also doubled from cycles 1 through 3 and doubled again from cycles 3 through 6. Of the 1,970 pregnancies that began as multifetal on ultrasound, 77.4% resulted in liveborn multiples. CONCLUSION(S): Providers should be aware of the cumulative probability of liveborn multiples to effectively counsel patients on this important issue. With nearly three-quarters of all women having live birth after up to six IVF cycles, it is encouraging to report a low incidence of liveborn multiples.
Authors: Sveta Shah Oza; Vikas Pabby; Laura E Dodge; Vasiliki A Moragianni; Michele R Hacker; Janis H Fox; Katharine Correia; Stacey A Missmer; Yetunde Ibrahim; Alan S Penzias; Robert Burakoff; Sonia Friedman; Adam S Cheifetz Journal: Clin Gastroenterol Hepatol Date: 2015-03-25 Impact factor: 11.382
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Authors: Laura E Dodge; Denny Sakkas; Michele R Hacker; Rachael Feuerstein; Alice D Domar Journal: J Assist Reprod Genet Date: 2016-11-26 Impact factor: 3.412
Authors: K C Humm; L E Dodge; L H Wu; A S Penzias; B A Malizia; D Sakkas; M R Hacker Journal: J Assist Reprod Genet Date: 2015-09-14 Impact factor: 3.412
Authors: Vikas Pabby; Sveta Shah Oza; Laura E Dodge; Michele R Hacker; Vasiliki A Moragianni; Katherine Correia; Stacey A Missmer; Janis H Fox; Yetunde Ibrahim; Alan Penzias; Robert Burakoff; Adam Cheifetz; Sonia Friedman Journal: Am J Gastroenterol Date: 2014-12-16 Impact factor: 10.864