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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RARE CASES IN GYNECOLOGY-OBSTETRICS
With the development of diagnostic and therapeutic techniques (such as ART techniques) and the immersion of new pathologies (such as COVID19), we are witnessing an increase in the incidence of pathologies that were previously described as rare or exceptional. the practitioner sometimes confronts difficult situations in these cases in diagnostic ...read more
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