The review highlights the need to redefine success in infertility treatments as a singleton live birth to reduce the maternal and perinatal complications associated with multiple gestations.
Supports redefining infertility treatment success around singleton births; leaves optimal strategies open for prospective evaluation.
OBJECTIVES: To outline maternal and perinatal consequences of iatrogenic pregnancies. METHODS: Review of recently published literature. RESULTS: The problems of iatrogenic pregnancies derive from major changes in the lifestyle of women during the second half of the 20th century, whereby the age at which childbirth is desired has advanced. At the same time, the naturally reduced fecundity of advanced age, as well as involuntary infertility, were met by new, effective, and costly, treatments. The side-effect of attempts to maximize success rates of such treatments was a remarkable increase in the numbers of multiple gestations, which are invariably associated with serious maternal and perinatal complications. CONCLUSIONS: The best method to reduce the impact of iatrogenic pregnancies is to re-define our concept of success after infertility therapy-from live birth (of any number of fetuses) to singleton live birth per treatment-and to adopt a conscientious and rational approach to achieve it.
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Isaac Blickstein (2003) studied this question.
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