The management of multiple pregnancies after induction for superovulation

The high rate of multiple pregnancies after embryo transferdepends upon the number of embryos replaced and amounts to {smalltilde}20% for four or more embryos. This incidence justifiesa preventive or curative treatment after the induction of superovulation.Aspiration of one or more embryos via the cervix under ultrasoundcontrol has been undertaken on 42 patients since 1983, and involvedtwo sextuplets, 10 quadruplets, 18 triplets and 12 twins. Twentysix embryo reductions were performed before 9 weeks of amenorrhoea.Five failures after 9 weeks were due, in the early stages ofthis procedure, to infection. In the case of twins, the indicationwas a scarred uterus in 10 cases and a psychiatric reason fortwo patients. In 19% of our cases delivery occurred within 32weeks of amenorrhoea.