Fertility Treatment May Carry Risk

Friday, July 7th 2000, 12:00 am
By: News On 6

Inducing ovulation to treat infertility carries a significant risk of producing unwanted multiple births, even when doctors carefully follow the standard guidelines, a study concludes.

Researchers who conducted the study say the only way of lowering the chances of producing triplets or more is to give less ovary-stimulating drugs, but this also significantly decreases the chance of producing a baby.

The researchers examined ovulation induction, which involves giving women drugs called gonadotropins to induce the release of eggs. This is the most common fertility treatment.

Dr. Norbert Gleicher and others reviewed data from the treatment of 1,494 women at the Center for Human Reproduction in Chicago. The treatments resulted in 314 single babies, 88 twins, 22 triplets, 10 quadruplets, five quintuplets and two sextuplets.

Doctors attempt to reduce the chances of so-called high-order multiple gestation — triplets or more — by monitoring the ovaries' egg production and checking blood hormone levels. However, these methods are imperfect, and the researchers concluded that one standard tool, ultrasound scans, is essentially worthless.

Cutting back on gonadotropins reduced the chances of multiple births, Gleicher said, but ``that would give you such a low pregnancy rate that no patient would accept this treatment.''

The researchers recommended that doctors instead rely exclusively on in vitro fertilization. With that method, two embryos typically are conceived outside the woman's body and then implanted in her uterus.

Gleicher said this costs two to three times more than ovulation induction but is also two to three times more likely to result in a pregnancy and eliminates the risk of triplets and quadruplets.

In an accompanying editorial in Thursday's New England Journal of Medicine, Drs. Siladitya Bhattacharya and Allan Templeton of the University of Aberdeen in Scotland urged avoiding aggressive ovary stimulation and instead recommended in vitro fertilization to implant one or two embryos.