In-vitro advance limits number of fertilized eggs Chance of multiple births falls as fewer eggs needed


SANTA ANA, Calif. -- The latest advance in the 20-year-old in-vitro fertilization field may also resolve one of its thorniest ethical issues: the transfer of too many fertilized eggs, resulting in potentially dangerous and expensive triplet, quadruplet and quintuplet births.

In September, an Orange County, Calif., clinic became one of a handful in the country that began growing fertilized eggs in a special nutritional solution for two or three extra days -- long enough for an eight-celled embryo to grow into one with too many cells to count. Fewer of these mature embryos are then needed to ensure pregnancy.

"For the first time we are going to have the ability to perform IVF with greater efficiency and with less risk to the patient," said Dr. -- Robert E. Anderson, who heads the Newport Beach-based Southern California Institute for Reproductive Sciences.

Typically, three or more fertilized eggs are transferred during IVF, a procedure performed on more than 40,000 women annually at a cost of $7,800 for each attempt.

The technique, coupled with the increased use of more potent fertility drugs, are the main reasons for the 344 percent increase in the number of triplets and other higher-order multiple births, according to the National Center for Health Statistics.

The rise has resulted in more preterm and low-birthweight babies in this country, common complications of multiple births. They can cost up to four times more to treat after birth than single babies -- an average of $36,500 each.

Additionally, women who are pregnant with three or more babies occasionally have to abort one or more to ensure the birth of at least one healthy child.

The new technique is called blastocyst transfer. Doctors have always known that fertilized eggs that make it to the blastocyst stage have a greater chance of implanting in a woman's uterus and beginning a pregnancy. With a greater success rate per embryo, they could transfer fewer embryos and thus reduce the risk of multiple births.

But until recently, the nutritional soup in which the embryos were grown rarely supported them beyond the third day.

Pub Date: 11/20/98

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