C. Corchia et al., WHAT PROPORTION OF MULTIPLE BIRTHS ARE DUE TO OVULATION INDUCTION - AREGISTER-BASED STUDY IN ITALY, American journal of public health, 86(6), 1996, pp. 851-854
Objectives. This study evaluated the increase in risk of multiple birt
hs associated with ovulation induction and calculated the proportion o
f multiple births attributable to this treatment. Methods. Cases were
350 multiple births and controls were 737 single births enrolled from
April 1993 to March 1994 in the Mercurio Project, an investigation of
reproductive outcomes in Italy. Results. Ovulation induction was used
in 45 case births (12.9%) and 24 control births (3.3%); the adjusted o
dds ratio was 4.1 (95% confidence interval [CI] = 2.4, 6.9). The odds
ratio for triplet or higher order births was 72.2 (95% CI = 25.7, 202.
8). When unlike-sexed multiple births were considered, the odds ratio
increased for twin births, but not for triplet or higher births. The h
ighest odds ratios were found when ovulation induction was used with a
ssisted reproduction. The proportion of multiple births attributable t
o ovulation induction was 9.7% overall, 5.4% for twin births, and 69.8
% for triplet or higher births. Conclusions: Ovulation induction incre
ases the risk of multiple births and has been responsible for the rise
in the rate of triplet or higher order births in Italy in the last de
cade. Its indiscriminate and im proper use should be avoided.