The Fertility Doc | IVF & Infertility Specialist Dr. David Kreiner

No More “Jon and Kate” Casualties

Posted on 06. Jul, 2009 by David Kreiner, MD in Single Embryo Transfer

Jon and Kate Plus Eight has brought the tragedy of the high order multiple pregnancy to the American living room. This is a subject that I was first introduced to when I entered the field of reproductive endocrinology and infertility in 1985 at the Jones Institute in Virginia. In those days, fertility treatments, like IVF were inefficient and we needed to transfer multiple embryos to ensure a reasonable chance for successful implantation. In 1985 a favorite patient of mine conceived with quadruplets. I lived through the pregnancy related issues she experienced, the birth and subsequent difficulties with some of the babies. There were numerous operations, hospitalizations and this added tremendous stress in their lives and in their marriage.

Over the years, I have seen numerous high order multiple pregnancies, a side effect of transferring numerous embryos with an inefficient procedure. I have experienced through my patients, pregnancy complications, antenatal and postnatal demise and difficulties and complications suffered by the babies. Many of these marriages failed to survive the stresses, some of the patients suffered depression and there were many issues with the babies.

I still feel the pains I experienced with my patients during those early years of IVF. We infertility doctors were responsible for many high order multiple pregnancies that often did not end well. And I carry that in my heart. When I opened East Cost Fertility, I swore that I would not be responsible again for any conception greater than twins. The only triplets I have had since 2002 are from an embryo transfer of two where the embryos split and created a third baby. I don’t ever want to be responsible for anything like that again. Then IVF was inefficient, today, the implantation rates are far superior. There is no excuse for octomom or sextuplets like Kate has had. I don’t feel gonadotropins with IUI is as safe as IVF where you can limit the number of embryos. We need to enforce the guidelines provided by the American Society of Reproductive Medicine so that programs and patients are compelled to be responsible and limit risk. There is a competitive pressure felt by IVF programs to transfer more embryos as their statistics and success rates are inspected by prospective patients. Programs have not unifomly followed these guidelines. It is only through outside regulation that we can prevent the cause of these high order multiple pregnancies.

I started the Single Embryo Transfer program at East Coast Fertility to encourage patients to limit the number of embryos replaced into the uterus to one in good prognosis patients by eliminating the financial factor. These patients are offered free cryopreservation, embryo storage and frozen embryo transfers so there is no financial pressure for patients to put all their eggs in one basket. This represents a savings of up to over $12,000 and ensures a better chance of a healthy pregnancy and healthy baby. It is my sincere hope that situations that led to the sextuplets of Jon and Kate and octomom are eliminated through regulations and financial incentives such as the Single Embryo Transfer program.

Tags: East Coast Fertility, high order multiple pregnancy, in-vitro fertilization, Infertility Information, IVF, jon and kate, kreiner, Octomom, Octuplets, Single Embryo Transfer