Afternoon Symposium - Ken Ryan Ethics Symposium - Multiple Pregnancy and ART
Time:4:15 pm - 6:15 pm
Location:Room 5 - San Diego Convention Center
Bonnie Steinbock, Ph.D. (Chair), University at Albany – SUNY
G. David Adamson, M.D., Fertility Physicians of Northern California
Bradley J. Van Voorhis, M.D., University of Iowa, Carver College of Medicine
Multiple Pregnancy and ART
Needs Assessment and Description
Multiple births, which pose increased risks of morbidity and
mortality to both mother and offspring, have increased
dramatically in the United States. In ART treatment, the main
risk factor for dizygotic and high-order multiple pregnancies
is the transfer of more than one embryo. Although many
experts advise single-embryo transfer (SET), fertility specialists
may come under considerable pressure from patients
to transfer more embryos, despite the risks, to avoid the
burdens and costs of additional cycles, especially since IVF
is often not covered by insurance. Professional organizations,
practitioners, patients and the public need to confront
the problem of multiple births and address the following
questions: What is the degree of risk caused by multiple
births? Should patients be able to direct the number of
embryos transferred? Should this be determined by practice
guidelines and, if so, what should the guidelines be? Is there
a case for legal limits, as in some European countries? This
live course will cover these questions and help practitioners
address it in their practices.
At the conclusion of this session, participants should be able
- Discuss the extent of the problem of multiple births, and
define the risks faced by both mothers and babies.
- Explain the problem in terms of the procreative liberty
of fertility patients versus the responsibility of the medical
profession to protect both patients and offspring from
After participating in this session, in my practice I will do the
- Recommend single embryo transfer for all patients,
regardless of prognosis.
- Not restrict the number of embryos transferred because
of the availability of multifetal pregnancy reduction.
- Make a decision with the patient about how many
embryos to transfer based primarily on patient age, and
counsel the patient on the risks of multifetal pregnancy.
- Not include prognostic factors and previous IVF history in
the decision of how many embryos to transfer.
- Not applicable to my area of practice.