Current Women`s Health Reviews

John Yeh  
Harvard Medical School 
Department of Obstetrics and Gynecology
Massachusetts General Hospital
Boston, MA
USA

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Attitudes of Infertile Couples to a Multiple Birth: A Review of theLiterature and Results from a Survey

Author(s): Christine Glazebrook, Charlotte Sheard, Laura Winstanley, Sara Cox, George Ndukwe.

Abstract:

Background: Although multiple births are associated with poorer clinical and psychological outcomes, there isa perception that couples choose multiple embryo transfer because they would prefer a multiple IVF birth. Objective :To review literature concerning the attitudes of infertile couples to a multiple birth and to explore factorsinfluencing couples decisions about embryo transfer. Methods: Thirteen research articles were identified in the medical literature that examined womens choices concerningmultiple IVF pregnancies. A cross-sectional survey was conducted at one centre for the treatment of infertility in the EastMidlands, UK. Sixty-eight couples undergoing in-vitro fertilisation (IVF) with at least two embryos available for transferwere recruited to the study. Outcome measures were couples ratings of factors influencing the number of embryostransferred. Results: Eight of the 13 studies found couples favouring a multiple birth to be in the majority. Most studies, however, hadrequired hypothetical or retrospective judgments. In the present survey no patient had chosen single embryo transfer(SET), 56 (76%) had had 2 embryos transferred and 16 (24%) had 3 embryos transferred. Patients strongly perceived thatSET would reduce the chances of having a child. Only 13 women (19.1%) considered that a desire for twins hadinfluenced their decision. Of more importance was the desire to increase the chance of pregnancy (92.7%), the medicaladvice received (91%) and a desire to avoid further treatment (57.3%). The majority of couples found the decisionregarding embryo transfer easy but a third would have liked more information. Participants with children were less likelyto report a desire for twins (p < 0.06) but other demographic factors had no influence. Conclusions: Although the literature has suggested that infertile couples have strongly positive attitudes to multiplepregnancies, most patients are not seeking a twin birth when they choose multiple embryo transfer and physicians have animportant role to play in helping patients make informed decisions.

Keywords: Single embryo transfer, IVF, patient decision making, double embryo transfer

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Article Details

VOLUME: 3
ISSUE: 1
Year: 2007
Page: [43 - 48]
Pages: 6
DOI: 10.2174/157340407779941877