Center for Reproductive Medicine Antwerp University H ospital Can we further reduce multiple pregnancies in Belgium Prof Diane De Neubourg Center for Reproductive ID: 1040611
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1. Prof. Diane De Neubourg Center for Reproductive Medicine - Antwerp University Hospital Can we further reduce multiple pregnancies in Belgium?
2. Prof. Diane De Neubourg Center for Reproductive Medicine - Antwerp University Hospital On behalf of the College of Physicians for Reproductive Medicine. BSRM 1 12 2017
3. OUTLINEWhat is the actual situation? Where are we compared to Europe (EIM 2013)?Can we do better? Scope for improvement? Analysis of the “remaining twins”Conclusions & recommendations
4. What is the actual situation?Belrap data 2015
5. Own fresh cycles 2015: number of deliveries
6. Own cryo cycles 2015: number of deliveries 6% twins
7. Fresh and thawed oocyte recipient cycles 2015: number of deliveries FreshThawed
8. Fresh and thawed oocyte recipient cycles 2015: number of deliveries
9. Where are we compared to Europe? Assisted reproductive technology in Europe 2013: results generated from European registers by ESHREBy the European IVF-monitoring consortium (EIM) for ESHRE Calhaz-Jorge et al., Hum Reprod 2017, 32; 10: 1957-73.
10. Calhaz-Jorge et al., Hum Reprod 2017, 32: 1957-73
11. Calhaz-Jorge et al., Hum Reprod 2017, 32: 1957-73
12. What about the remainig twins?Analysis of the Belrap data 2010-2015
13. Fresh cyclesNumber of twins (absolute figures)2010-2015Rank of the cycleAge category (<36; 36-37; 38-39; 40-42)Day of transfer (cleavage stage versus blastocyst stage)Twin births after a previous IVF birth.
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20. Fresh cyclesPercentage of twin births compared to all births2010-2015Rank of the cycleAge category (<36; 36-37; 38-39; 40-42)Day of transfer (cleavage stage versus blastocyst stage)
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23. Cryo cyclesNumber of twins (absolute figures)2010-2015Rank of the cycleAge category (<36; 36-37; 38-39; 40-42)Twin births after a previous IVF birth.
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27. Cryo cyclesPercentage of twin births compared to all births2010-2015Age category (<36; 36-37; 38-39; 40-42)
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29. ConclusionsOwn fresh cycles (2010-2015) The highest number of twin births are in the age category <36 in all the cycle ranks and in age category 36-39 in first and second cycles. Multiple birth rate remains high in all age categories until 40 (range 10-20% over all ranks).Most twin births still come from cleavage stage embryos, but the proportion twin births after D2-3 versus D5-6 is changing.Multiple birth rate after D5-6 transfer is higher than on D2-3 high in all age categories.There is an important number of twin births in 2015 after a previous IVF live birth (2010-2015) particularly in <36 age group.
30. ConclusionsOwn cryo cycles (2010-2015) The highest number of twin births are in the age category <36 with an important number of twin births after a previous IVF pregnancy.Multiple birth rate is more or less the same in all age categories until 42 years of age (range 7-10%).
31. RecommendationsSET for women <36 at least in first 3 to 4 fresh cyclesall cryo cyclesD5 transferAfter a previous IVF birth SET for women 36-39 in first 2 fresh cycles (consider in cryo cycles and after a previous birth). Bear in mind that the twin birth rate is high for all age categories until 40 (42) when counselling the individual patient!
32. THANK YOU