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In the United States, triple, quadruple, or more births are on the decline.
In the year Between 1998 and 2023, the rate of triplet and tertiary births in the US will decrease by 62%; Report Published Thursday by the US Centers for Disease Control and Prevention. And the biggest price drop was seen among mothers 30 and older.
This decline reflects how guidelines around the transfer of embryos during the use of assisted reproductive technologies, known as IVF, have been strengthened, the researchers from the CDC's National Center for Health Statistics wrote.
They are a couple. They are more likely to have twins.Triplets or more babies in one pregnancy When using assisted reproductive technology, these fertility treatments may involve transferring multiple embryos into the uterus in the hope that pregnancy will result.
Multiple embryos not only increase the chance of a healthy pregnancy, but the pregnancy can include more than one embryo – so it can be twins, triplets or more.
“Monitoring trends in triplet and higher order multiple births is important because women with triplet/+ pregnancies are at increased risk of complications during pregnancy and their infants are at higher risk of preterm birth and infant mortality,” said Joyce Martin, a researcher at the National Center for Health Statistics and lead author of the report. As the author said in an email.
In the year As fertility treatments became more mainstream after the 1980s, the incidence of multiple births increased, said Dr. Micah Hill, president of the Society for Assisted Reproductive Technology, who was not involved in the new report.
In the year In the early 2000s, the American Society of Reproductive Medicine and the Society for Assisted Reproductive Technology began setting guidelines for how many embryos should be transferred under various circumstances. This guide is here to help. Reduce the risk of problems For women undergoing fertility treatment, including prenatal risk.
While The new data does not indicate how many births are conceived spontaneously through assisted reproductive technologies (ART) such as IVF. They appear parallel to the entrance Instructions.
Guidelines Released in 2004, Hill said, and updated in 2006, 2008, 2009, 2013, 2017, and 2021.
“If you look at the CDC's numbers, you can see these declines follow every year or two after these guideline updates happen,” Hill said.
“These guidelines are as the technology evolves,” he said. “I think it was successful in making fertility treatments safer, which is really what worries us when we're talking about reducing these high-level multiples.”
In part, recommendations by Close instructionsIn the year Published in 2021, it ranges from recommending only one embryo to be transferred at a time for patients under 35 to recommending no more than four undiagnosed primary embryos for patients over 40.
It's not just the guidelines on embryo transfer that have changed in the past decade, perhaps leading to a decline in triplets and higher birth rates.
There have also been changes in the use of fetal reduction during fertility treatment, a procedure used to reduce the number of fetuses in triplet or more pregnancies, said Dr. Amanda Williams, an interim physician at the Maternal and Infant Health nonprofit March of Dimes, who was not involved in the NCHS data.
She called the new NCHS report “great news” for maternal and infant health, showing a decline in singleton, triplet and multiple birth rates.
“When you have three or more babies in you, there's a higher risk of preterm birth, low birth weight, infant death, NICU stay, and then on the maternal side, gestational diabetes, gestational diabetes like preeclampsia,” she says. “So this is good for families.” It's news, because triplets and high-risk pregnancies are very dangerous for mother and baby.”
In previous years, the number of triplet and higher births in the United States increased from 37 per 100,000 births in 1980. All time high About 194 births per 100,000 in 1998, the new report.
This “unprecedented growth” in older women and “an increase in fertility treatment,” Martin and co-author Michelle Osterman wrote in the report.
“The development is a public health concern due to the high incidence of triplet and multiple births compared to singletons and twins,” they wrote.
But since 1998, the rate of triplet and multiple births in the United States has dropped to about 74 per 100,000 births in the previous year, the new data show.
In the year Between 1998 and 2009, the rate decreased, but not significantly, falling 21% to 154 per 100,000 births in 2009. In the year From 2009 to 2023, rates fell sharply by 52%, according to the new report, which is based on birth certificates. Data from CDC's National Vital Statistics System. Many people You may remember 2009, the year Nadia Suleman, known to the media as Octomom, gave birth to eight babies in one birth after undergoing IVF.
The new data shows that between 1998 and 2023, births in the United States fell by 65% - from 7,625 births in 1998 to 6,340 in 2009. 2,653 births last year.
The new data “reflects what we've seen on the ground,” said Dr. Asima Ahmed, an endocrinologist and fertility specialist and founder of Carrot Fertility, a company that helps employers prepare. Fertility benefits.
“Fembryo labs have advanced over the years, allowing the fetus to grow further than it was years ago. There are additional tests that can provide more information about the health of the fetus,” Ahmed, who was not involved in the new NCHS report, said in an email. It is becoming increasingly common for a physician to transfer one embryo at a time to achieve the goal of an alternative singleton pregnancy.”
Looking at the data by maternal age, the researchers found that from 1998 to last year, the rate of triplet and multiple births for mothers aged 20 to 24 decreased by 16%. 57% for mothers aged 25 to 29; 77% for mothers aged 30 to 34 and 35 to 39; and 67% for mothers 40 and older.
The researchers also found significant racial differences.
Among white mothers, the rate of triplet and multiple births decreased by 71% from 1998 to last year. Triplet and supernumerary births to Hispanic mothers declined by 25 percent from 1998 to 2023.
However, the triplet and senior birth rate for black mothers followed a different trend, rising 21 percent from 1998 to 2009 and remaining largely unchanged from 2009 to 2023, a 25 percent overall increase from 1998 to last year.
“The biggest drops are white women over the age of 30, and that's the group with the highest access to in vitro fertilization and proper embryo transfer,” says March of Deems Williams. he said.
But there are many other types of assisted reproductive technology, she says, that may be factors affecting racial disparities.
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“When you think about black women or when you think about low-income women, they may not have access to the highest levels of technology and IVF assisted reproductive technologies,” Williams said.
“They may be using advanced reproductive technology methods — like clomiphene with insemination, where you stimulate the ovaries to produce more eggs, so you're doubling and tripling your number,” she said. “So we cannot link assisted reproductive technology to IVF. There are less invasive, technologically advanced forms of assisted reproductive technology being used by black mothers and low-income mothers.
Overall, the new data was “very informative,” said Dr. Rachel McConnell, assistant professor of obstetrics and gynecology. Columbia University Vagelos College of Physicians and SurgeonsNot involved in the report, it is in the email.
She added that the report's findings suggest that the American Society of Reproductive Medicine's guidelines for transferring low-number embryos “have helped reduce the number of multiple pregnancies in IVF cycles.”