The use of ART in industrialised countries has become a routine infertility treatment. In the last 10 years there have been many research articles comparing pregnancy complications and obstetric risk in twin and singleton IVF/ICSI pregnancies, with those of a natural conception (Lambers et al 2007, Ochsenkuhn et al 2003, Tallo et al 1995).
A recent study from Canada (Allen et al 2006) which reviewed articles from 1995 to 2005 on the effect of ART on perinatal outcomes and obstetric risk showed that there is a definite link to a higher risk of perinatal complications, due mainly to the higher incidence of multiple pregnancies. These include pregnancy-induced hypertension, preterm birth, low birthweight, abruptio placentae and placenta praevia. The outcomes of that study and others have lead to a push from the medical world for single embryo transfer in ART, especially at blastocyst stage (Jansen & Sullivan 2006, Pinborg et al 2004). However, the study stated: 'it remains unclear if these increased risks are attributable to the underlying infertility, characteristics of the infertile couple, or use of the assisted reproductive techniques' (Allen et al 2006).
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