Article
Multiple pregnancies after assisted reproduction – international comparison

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Abstract

The high incidence of multiple pregnancies after application of techniques for assisted reproduction is a phenomenon of major concern worldwide. High order multiples in particular have to be regarded as a serious adverse event. However, data show that in Europe, although the situation varies from country to country, multiple births, especially triplet births, as consequence of assisted reproductive technology are on the decline. New strategies such as elective single embryo transfer, emphasized especially by Finland and Sweden, open up new pathways towards safer treatments, reducing the incidence of high order multiples to almost zero while maintaining high pregnancy rates. Compared with Europe, in the US, more than half of all children delivered after assisted reproduction are multiples. While an incidence of 33% of multiple births may seem to be acceptable, an incidence of 54% of children born as multiples, moreover high order multiples, is certainly not. The enormous impact of legal and financial regulations on the attitude of physicians and patients regarding assisted reproduction can be observed at the moment in Germany, with a dramatic decline in number of treatments. However, the incidence of multiples has not increased.

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Ricardo Enrique Felberbaum was born in 1961 in Frankfurt am Main. He studied human medicine at the University of Cologne and became MD in 1986. After clinical specialization as a gynaecologist and obstetrician, he joined the group of Klaus Diedrich at the Medical University of Lübeck in 1993. Since then he has done extensive investigations in the use of GnRH antagonists for ovarian stimulation in assisted reproduction treatment, as well as in the treatment of uterine fibroids and endometriosis.

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Ricardo Enrique Felberbaum was born in 1961 in Frankfurt am Main. He studied human medicine at the University of Cologne and became MD in 1986. After clinical specialization as a gynaecologist and obstetrician, he joined the group of Klaus Diedrich at the Medical University of Lübeck in 1993. Since then he has done extensive investigations in the use of GnRH antagonists for ovarian stimulation in assisted reproduction treatment, as well as in the treatment of uterine fibroids and endometriosis. Since 1996 he has been the chairman of the German national IVF registry.

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