Fetal reduction as treatment of multifetal pregnancy

Dear Dr.White

Your article points out the conundrum that many infertile couples face when getting treatment for infertility. However you selectively left out plan C: Selective reduction.

Perhaps the worst complication of assisted reproduction procedures is a multifetal pregnancy—that is, a pregnancy involving more than one or two fetuses. The desire to achieve a pregnancy creates a strong incentive for patients to produce multiple embryos with IVF. However, the financial and emotional costs of these pregnancies are unacceptable.

Fetal reduction is the termination of one or more of these fetuses, leaving the rest to continue to term. With success rates of 80 percent or more, this procedure appears both relatively safe (for the mother and the remaining fetuses) and an effective alternative to avoiding the many complications associated with pregnancies greater than twins or triplets. The procedure is usually performed between 9 and 11 weeks of pregnancy.

Carlos T Mock, MD
Chicago, IL