Mitigating multiples, less is more: examining trends in multifetal gestation rates with assisted reproductive technology

J Assist Reprod Genet. 2024 Sep;41(9):2301-2310. doi: 10.1007/s10815-024-03208-4. Epub 2024 Jul 31.

Abstract

Purpose: Multifetal gestation (MFG) is much more common in pregnancies that utilize assisted reproductive technologies (ART). We assessed how these rates have changed over the previous decade and the impact on live birth rates (LBR).

Methods: This retrospective cohort study uses the National Summary Reports of the Society for Assisted Reproductive Technology (SART) from 2014 to 2020. Data points included only autologous cycles. The data were divided into five age groups as reported in the database: < 35, 35-37, 38-40, 41-42, and > 42 years old. Descriptive statistics and a two-tailed T-test were used to determine the trends and statistical significance (p < 0.05).

Results: Rates of twin births decreased substantially from 2014 to 2020 for autologous embryo transfers across all age groups and diagnoses. Surprisingly, the overall LBR for autologous IVF cycles decreased at similar rates from 2014 to 2020 in all age groups. The mean number of embryos transferred has dramatically reduced, especially across age groups < 42.

Conclusion: Rates of twin and higher-level gestations have decreased substantially over the past decade; the effect correlates with the increased utilization of eSET and PGT. The cause of infertility did not significantly impact the rate of MFG.

Keywords: Elective single embryo transfer; In vitro fertilization; Live birth rate; Multiple fetal gestations; Twins.

MeSH terms

  • Adult
  • Birth Rate / trends
  • Embryo Transfer* / methods
  • Embryo Transfer* / trends
  • Female
  • Fertilization in Vitro* / trends
  • Humans
  • Live Birth / epidemiology
  • Pregnancy
  • Pregnancy Rate
  • Pregnancy, Multiple* / statistics & numerical data
  • Pregnancy, Twin / statistics & numerical data
  • Reproductive Techniques, Assisted* / statistics & numerical data
  • Reproductive Techniques, Assisted* / trends
  • Retrospective Studies