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In Vitro -- with Fewer Multiple Births

January/February 1999

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Couples going through the nerve-wracking process of in vitro fertilization may soon have one less thing to worry about: quintuplets. Stanford Medical School researchers have developed a new technique to help patients achieve a high pregnancy rate "without having to gamble too much with a risk of having more than twins," says Amin Milki, associate professor of medicine and medical director of Stanford's IVF and Assisted Reproductive Technology Lab.

To maximize the chances of pregnancy, fertility doctors typically transfer four or five fertilized eggs into the uterus. But if most of the embryos successfully implant in the uterus, couples find themselves facing a wrenching choice: rear multiple babies or abort one or more embryos.

The new technique reduces this problem by using a lab technique formulated by Barry Behr, director of the IVF program. Embryos stay in Behr's specialized culture for five days rather than the usual three. The extended period mimics nature's timing more closely and allows doctors to discern which embryos are likely to thrive best after being implanted.

Of the first 43 women to undergo the procedure at Stanford, 30 became pregnant -- nearly a 70 percent success rate, compared to just under 30 percent for the conventional technique. The first woman to undergo the procedure delivered a healthy 7-pound baby last summer. Doctors now are hoping to extend the option to women who have had multiple in vitro failures, women over 40, and those using donor eggs.

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