Fertility Treatments and Multiple Births in the United States

To the Editor: Kulkarni et al. (Dec. 5 issue)(1) state that increases in the rates of multiple pregnancy associated with fertility treatments are mostly due to aging of treated patients and clinical utilization of fertility-enhancing drugs aside from in vitro fertilization (IVF) treatments.(1) In 2000, we pointed out that even under professional infertility care, such treatments resulted in rates of 20.0% for twin births and 8.8% for higher-order births (triplets or more), for a combined multiple-pregnancy rate of 28.8%.(2) Among general obstetrician-gynecologists, who perform most non-IVF treatments, the rates of multiple births can be expected to be even higher. Thus, ...