SINGLETON AND TWIN CONFINEMENTS ASSOCIATED WITH INFERTILITY TREATMENTS

This paper provides important data concerning the contribution of the different infertility treatments (clomiphene plus gonadotrophin versus GIFT plus IVF) to the community incidence of twin pregnancy. It seems to us that sampling only 0.6% of singleton pregnancies and 50% of twin pregnancies (table 3) may have underestimated the contribution to singleton pregnancy of both CC/GT and GIFT/IVF. Ideally, what we require is documentation on all the perinatal data forms of whether the index pregnancy resulted from treatment with CC/GT or GIFT/IVF-the multiple pregnancies rates (twin and higher order multiples) associated with these different treatment regimens could then be evaluated for the total population. This would give a new dimension to informed decision by the doctor and the infertile couple in selection of the method of treatment of infertility in those women who have patent tubes and are thus suitable candidates for either regimen. Knowledge of the twin and higher order multiple pregnancy rate, not to mention the rate of singleton pregnancy, associated with these 2 different regimens would also indicate if present drug regimens require further refinement to be competitive with GIFT and IVF, i.e. in terms of the community incidence of twin delivery but exclusive of other cost considerations.