INTERNATIONAL, COLLABORATIVE EXPERIENCE OF 1789 PATIENTS HAVING MULTIFETAL PREGNANCY REDUCTION - A PLATEAUING OF RISKS AND OUTCOMES

OBJECTIVE: To develop the most up-to-date, complete data base of multi fetal pregnancy reduction (MFPR) from cases, and to provide the best c ounseling for couples with multifetal pregnancies, METHODS: From nine centres in five countries, 1789 completed MFPR cases were allowed and outcomes evaluated. Pregnancy losses were defined as through 24 weeks and deliveries categorized in groups of 25-28, 29-32, 33-36, and 37 or more weeks. RESULTS: Overall, the pregnancy loss rate was 11.7% but v aried from a low of 7.6% for triplets to twins and increased with each additional starting numbers to 22.9% for sextuplets or higher. Early premature deliveries (25-28) weeks were 4.5% and varied with starting number. Loss rates by finishing number were highest for triplets and l owest for twins, but gestational age at delivery was higher for single tons. CONCLUSIONS: Multifetal pregnancy reduction has been shown to be a safe and effective method to improve outcome in multifetal pregnanc ies, Outcomes are worse with higher-order gestations and support the n eed for continued vigilance of fertility therapy.