The Risks of a Multiple Gestation Pregnancy Resulting from Infertility

Treatment

Rachel C. Delp- BiopsychologyDepartment of Biological Sciences

My Internship

• I spent more than 200 hours as an intern at The Center for Advanced Reproductive Medicine and Fertility office in Edison, NJ

• My function was to shadow the clinical staff, learn everything that encompasses the field of infertility treatment

• I discussed procedures with current and prospective patients

Objective of Thesis• As I mentioned before, my internship gave me

insight into the practical field of infertility treatment.

• Based on my experience, I selected to write my thesis about the risks of a multiple gestation pregnancy resulting from infertility treatment because I believe couples who undergo infertility treatment do not thoroughly understand the potential risks of having a multiple pregnancy.

• The options include in vitro fertilization (IVF) and intrauterine insemination (IUI)

• Each year, 1.25 million women of reproductive ages 15-44 will seek infertility care (Hogue, 2002)

• Due to the increased use of fertility medications and assisted reproductive technology (ART) the frequency of multiple gestations is up by 70 % since 1980 (Belogolovkin and Stone, 2007)

• These medications manipulate the human body into producing more mature follicles than it would in a natural woman cycle

Monitoring of follicles under ultrasound in addition to checking the estrogen level is vital in determining the number and size of follicles and time of ovulation.

• Financial burdens often lead couples who select IVF treatment into making bad decisions by asking to implant more embryos in order to avoid going through another costly treatment cycle• These decisions are often what

lead to a multiple gestation

• 98% of women who are pregnant with multiple fetuses (especially with three or more) are subjected to serious health complications and need rigorous prenatal care and possibly antenatal hospitalization

• Like all of you know in California during 2009, a single, unemployed mom gave birth to live-born octuplets. The media gave her the name Octomom.

• She remained in the hospital for seven weeks before she gave birth to the octuplets.

• If a third of triplets are born extremely premature and are twelve times more likely to die during the first year of life than singletons, one can imagine how a higher number of multiple gestations will have a health effect on both the mother and the fetuses

• The good news is that there are several treatment options available for helping the mothers and their babies

• For example, a procedure has been developed that reduces the multiple pregnancy down to a double or single pregnancy known as Multifetal Pregnancy Reduction (MFPR).

• The MFPR procedure is typically performed during the tenth through twelfth week of gestation.

• In conclusion, I emphasize here the three of my main messages that I usually deliver to those patients with whom I discuss their case

1. The human body is made to carry and deliver no more than two babies during one pregnancy

2. Due to financial issues, many couples who are using IVF select to implant more embryos thus, hoping to avoid the cost of another IVF cycle. Most fail to see that a multiple pregnancy will end up costing them more money in the future than go through another cycle

3. For those who become pregnant with multiples they have to seriously consider going through the Multifetal Pregnancy Reduction (MFPR)

Acknowledgment

• Dr. Gregory H. Corsan• Renee Kurland• Kevin Kessler• Christine Angeles-Bojar• Dr. Zoltan Fulop• Dr. Ammini S. Moorthy• Professor Linda Raths