Lectures

Systematic single embryo transfer (sET) should not be used to prevent all multiple pregnancies

Lecture Type: Conferences

Systematic single embryo transfer (sET) should not be used to prevent all multiple pregnancies

Norbert Gleicher, MD, FACOG

Dr. Norbert Gleicher founded the Center for Human Reproduction (CHR) in 1981. He is a graduate of Tel Aviv Medical School, Israel, and completed his residency at the Mount Sinai School of Medicine in New York. Dr. Gleicher was appointed to the facility as an Assistant Professor in charge of student and resident education in Obstetrics and Gynecology, and became Chief of the Section for Reproductive Immunology. Two years later, he moved to Chicago when he was offered the position of Chairman of Obstetrics and Gynecology at the Mount Sinai Hospital Medical Center, Professor of Obstetrics and Gynecology and Associate Professor of Immunology/Microbiology at Rush Medical College. He held his position as Chairman for 10 years, until his resignation in 1990. Since then, he has held a variety of academic and administrative positions. Dr. Gleicher is currently Medical Director and Chief Scientist of CHR-New York. Dr. Gleicher has published hundreds of peer-reviewed scientific papers, abstracts and book chapters in the areas of reproductive endocrinology and infertility, as well as in areas of medical complications in pregnancy. He has edited some of the most prestigious textbooks in these specialties and has served as the Editor-in-Chief for the American Journal of Reproductive Immunology and Microbiology and the Journal of In Vitro Fertilization and Embryo Transfer, which was renamed the Journal of Assisted Reproduction and Genetics in 1992. Dr. Gleicher serves as ad hoc reviewer and editorial board member for many other medical journals. He is a Fellow of the American College of Obstetricians and Gynecologists and, in addition to many other societies and professional organizations, a member of the American Society for Reproductive Medicine (ASRM) and the European Society of Human Reproduction and Embryology (ESHRE). He was chosen by Chicago magazine and other organizations as being amongst the ‘best physicians’ in reproductive endocrinology and infertility, as well as obstetrics and gynecology, as designated by his peers. In January 2009, Dr. Gleicher was invited to give the prestigious Patrick Steptoe Memorial Lecture to the British Fertility Society, as a recognition of his lifelong contribution to the advancement in reproductive endocrinology and infertility.

Context

An international trend has recently arisen to prevent twin pregnancies through mandatory elective single embryo transfer (sET). The reasoning by the proponents of mandatory sET is that twin pregnancies are an adverse outcome of assisted reproductive technologies (ART). However, literature search via PubMed and MEDLINE to assess maternal and perinatal/neonatal risks as well as cost comparisons for singleton vs. twin pregnancies reveal that twin pregnancies are sometimes a desirable outcome of ART. Most risk assessments of twin pregnancies after fertility treatment have used spontaneous conceptions data, which reflect different treatment paradigms and outcome benefits from pregnancies after fertility treatments. IVF twins demonstrate approximately 40% lower outcome risks than spontaneous twin conceptions. Most risk assessments in the literature are calculated with pregnancy as the primary outcome, but in a fertility-treatment paradigm, where patients want more than one child, the statistically correct risk assessment should refer to born children as the primary reference. If published data are corrected accordingly to achieve statistical commonality of outcome (i.e., one child in singleton versus two children in twins), twin pregnancies no longer demonstrate a significantly increased risk profile and/or higher cost for mothers or individual offspring. For infertile patients who want more than one child, twin deliveries represent a favorable and cost-effective treatment outcome that should be encouraged, in contrast to the current medical consensus.

VIDEO: Norbert Gleicher, MD, FACOG


Recorded on: December 10, 2011

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