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 There is a higher rate of multiple births
for women treated with fertility drugs than in the general population. The actual rate depends on the type of drugs
used and the chosen procedure. There are many strategies to minimize the risk of multiple births, but it is always
a risk to some degree.
There are three basic types of therapy
that increase the risk of multiple births. They are:
1. Ovulation induction with clomiphene
2. Ovulation induction with gonadotropins
3. IVF procedures with fertility drugs
They are discussed below:
1. Ovulation Induction with Clomiphene
The most commonly used "fertility drug" is clomiphene (Serophene or Clomid). It is an oral tablet
usually taken days 5 days (I use it days 3-7) of the menstrual cycle. The overwhelming majority of births are to
a single baby. The multiple birth rate for clomiphene is between 5% and 10%. The vast majority of these multiples
are twins. There are periodic reports of triplets or more, but these are rare and limited with proper monitoring.
In our practice, we have experienced an 11% twinning rate and produced one set of quadruplets.
2. Ovulation Induction with Gonadotropins
The next most common use of fertility drugs is for ovulation induction with gonadotropins (Pergonal, Gonal-f,
Fertinex, Follistim, Repronex and Humegon). This is sometimes called a stimulated IUI cycle. Again, the majority
of the births with the help of these drugs are to a single baby. Multiple births can be limited with proper monitoring.
For ovulation induction with gonadotropins, we have a 13% twinning rate. We have had 3 sets of triplets and 1 set
of quadruplets over the last 20 years.
3. In vitro fertilization procedures
with fertility drugs
The last use of fertility drugs is for assisted reproductive technologies, such as IVF. The overwhelming number
of deliveries is a single baby. Twins happen with some frequency (17%), but triplets and quadruplets are rare.
We have had 3 sets of triplets. The risk of multiple births is significant. Proper monitoring can minimize your
risks, but not eliminate them. Using a new technique for IVF called Blastocyst Transfer, reducing multiple births
even further shows some significant promise.
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