In vitro fertilization and non-IVF fertility treatments are major risk factors for multiple births .
IVF procedures, in which eggs and sperm are manipulated to establish a pregnancy, are the majority of assisted reproductive procedures.
Ovulation induction and ovarian stimulation coupled with timed intercourse or intrauterine insemination also utilized to establish a pregnancy.
In ovulation induction, ovulation is induced by drugs in women who are anovulatory.
Ovarian stimulation utilizes drugs to promote multifollicular ovarian development and ovulation.
Assisted reproductive technology allows many couples who would otherwise not be able to have children to have successful pregnancies.
Multiple embryo transfer increases the chance of pregnancy and the likelihood of adverse pregnancy outcomes, particularly due to preterm delivery.
Assisted reproductive technology increases the risk of adverse obstetrical and perinatal outcomes compared with spontaneous conception, even with single pregnancies.
Multiple births associated with fertility treatments related to increased health risks for women and offspring.
To decrease multiple births the number of embryos transf2242ed during IVF is limited.
Non-IVF fertility treatments account for more multiple births than IVF.
High incidence of multiple births is a consequence of advanced maternal age at delivery and fertility therapy.
It is estimated a total of 36% of twin births and 77% of triplet and higher order births are attributed to medically assisted conception(Kulkarni AD et al).
The rate of triplet and higher order births peaked in 1998 and have been declining since that time.
The decrease in the number of embryos transf2242ed during IVF accounts for the decline in triplet and higher order births.