Iatrogenic multiple pregnancies in East Flanders, Belgium.

OBJECTIVE

To evaluate the specific contribution of artificial induction of ovulation to the increasing number of multiple gestations in East Flanders and the effects of this treatment on the frequencies of monozygotic and dizygotic twinning.

DESIGN

Since 1976 the East Flanders Prospective Twin Study has collected data on artificial induction of ovulation for all the multiple births listed in its registry.

SETTING

East Flanders Prospective Twin Survey.

PATIENTS

Between 1976 and 1992, 458 twin and 78 triplet pregnancies resulting from artificial induction of ovulation were analyzed.

MAIN OUTCOME MEASURES

Zygosity and frequency of iatrogenic multiple births.

RESULTS

Since 1985 there is an explosive increase in twin and triplet births in East Flanders. This increase has been caused mainly by the sole use of fertility-enhancing drugs and in the last few years by resorting to other technologies of assisted reproduction, such as IVF-ET, GIFT, or zygote intrafallopian transfer.

CONCLUSION

In view of the elevated risk inherent to multiple pregnancies in terms of perinatal mortality and morbidity, the over enthusiastic or improper use of fertility drugs should be curtailed.