The management of multiple pregnancies after induction for superovulation

The high rate of multiple pregnancies after embryo transfer depends upon the number of embryos replaced and amounts to approximately 20% for four or more embryos. This incidence justifies a preventive or curative treatment after the induction of superovulation. Aspiration of one or more embryos via the cervix under ultrasound control has been undertaken on 42 patients since 1983, and involved two sextuplets, 10 quadruplets, 18 triplets and 12 twins. Twenty six embryo reductions were performed before 9 weeks of amenorrhoea. Five failures after 9 weeks were due, in the early stages of this procedure, to infection. In the case of twins, the indication was a scarred uterus in 10 cases and a psychiatric reason for two patients. In 19% of our cases delivery occurred within 32 weeks of amenorrhoea.