re: The IVF Ruling Puts Republicans in a Bad Spot Just Before the Election

Every time IVF occurs, multiple embryos are inserted to help ensure one or more implants. If 2 or more implant, which happens in many cases, selective reduction is recommended by the OB.

Article about selective reduction from the American College of Obstetricians and Gynecologists

“Spontaneous multifetal pregnancies have always posed increased medical risks to pregnant women and their fetuses. Between 1980 and 2009, the increased use of assisted reproductive technology and controlled ovarian hyperstimulation with gonadotropins resulted in a dramatic increase in the incidence of multifetal pregnancies. More recently, advances in laboratory techniques and a national effort by professional groups have led to greatly improved live birth rates despite the transfer of fewer embryos, which has significantly reduced the incidence of twins and higher-order multiple births 2. As an example, between 1980 and 2009, the twin birth rate increased 76%, from 18.9 to 33.3 per 1,000 live births 3. It has since stabilized and is currently 33.5 twins per 1,000 live births 4. The birth rate for higher-order multiples increased more than 400% between 1980 and 1998, when it peaked at 1.935 per 1,000 births 3. Between 1998 and 2015, deliveries of higher-order multiples decreased by 46% to 1.036 per 1,000 births 4. Although these advances have reduced the rate of higher-order multifetal pregnancies after in vitro fertilization (IVF), the risk remains higher than with naturally achieved pregnancies. Unlike with IVF, fertility treatments that involve controlled ovarian hyperstimulation with gonadotropins do not control for the number of eggs fertilized or embryos implanted. As such, the risk of a higher-order multifetal pregnancy is increased compared with IVF. This risk is estimated to be 9% 5.”