A 47-Year-Old Woman With Fertility Problems Who Desires a Multiple Pregnancy
- Robert J. Stillman, MD, Discussant
- Author Affiliations: Dr Stillman is Medical Director, Shady Grove Fertility Reproductive Science Center, and Clinical Professor of Obstetrics and Gynecology, Georgetown University School of Medicine, Washington, DC.
- Corresponding Author: Robert J. Stillman, MD, Shady Grove Fertility Center, 15001 Shady Grove Rd, Rockville, MD 20850 (robert.stillman{at}Integramed.com).
Abstract
Mrs Z is a 47-year-old woman with long-standing infertility who is about to undergo in vitro fertilization (IVF) using donor oocytes from an anonymous donor. She has already undergone an IVF cycle with her own oocytes and an IVF cycle using donor oocytes from a known donor without a successful pregnancy. Mrs Z has been advised by her infertility physician to consider the transfer of a single embryo, but she does not wish to decrease her likelihood of conception, and, after her long and expensive infertility saga, wishes to conceive twins. The science of IVF has evolved significantly in the last several years, increasing the likelihood of successful pregnancy and reducing the need to transfer more than 1 embryo with its inherent risks of multiple pregnancy. The state of the science and why patients may continue to want multiple embryos transferred, including costs and lack of insurance coverage for infertility treatments, are discussed.
This conference took place at the Obstetrics and Gynecology Grand Rounds held at Beth Israel Deaconess Medical Center, Boston, Mass, on April 12, 2006.
Clinical Crossroads at Beth Israel Deaconess Medical Center is produced and edited by Risa B. Burns, MD, Eileen E. Reynolds, MD, and Amy N. Ship, MD. Tom Delbanco, MD, is series editor.
