Document Detail


Practice patterns among board-certified reproductive endocrinologists regarding high-order multiple gestations: a united states national survey.
MedLine Citation:
PMID:  11978285     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess current practice management, attitudes, and strategies of reproductive endocrinologists in the United States regarding high-order (at least three) multiple gestations. METHODS: Questionnaires were mailed to 768 board-certified reproductive endocrinologists of whom 722 were eligible for the study. The questionnaires addressed topics such as practitioner demographics, management strategies, and attitudes regarding high-order multiple gestations. RESULTS: The survey response rate was 52%. Most physicians performed 100-300 cycles of each ovulation induction with intrauterine insemination and in vitro fertilization in 1998 and 1999. The most commonly reported incidence of high-order multiple gestations resulting from each ovulation induction with intrauterine insemination and in vitro fertilization was 2-5% in 1998 and 1999. Strategies used to decrease the rate of high-order multiple gestations varied among practitioners. Informed consent regarding high-order multiple gestations was provided by 99.5% of practitioners. Information regarding selective reduction was provided by 98.3% of respondents. Over 90% of practitioners believed it is worthwhile to attempt to decrease the risk of high-order pregnancies at the risk of decreasing their group's overall pregnancy rates. CONCLUSION: Most reproductive endocrinologists reported concern over the rising risk of high-order multiple gestations resulting from therapies such as superovulation with intrauterine insemination or in vitro fertilization. However, the ways in which patients are counseled regarding such events, their sequelae, and methods to avoid them greatly differ among respondents. Given the inconsistent practice patterns, a multifaceted educational approach may provide an opportunity to reduce the incidence of high-order multiple gestations and their sequelae.
Authors:
Doreen L Hock; David B Seifer; Eftichia Kontopoulos; Cande V Ananth; Efthica Kontopoulos
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  99     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-04-29     Completed Date:  2002-09-19     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  763-70     Citation Subset:  AIM; IM    
Affiliation:
Reproductive Medicine Associates of New Jersey, Somerset, USA.
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MeSH Terms
Descriptor/Qualifier:
Counseling
Endocrinology*
Female
Fertilization in Vitro / adverse effects,  statistics & numerical data
Health Surveys
Humans
Informed Consent
Insemination, Artificial / adverse effects,  methods,  statistics & numerical data
Ovarian Follicle / physiology
Ovulation Induction / adverse effects,  statistics & numerical data
Physician's Practice Patterns*
Pregnancy
Pregnancy Reduction, Multifetal
Pregnancy, High-Risk*
Pregnancy, Multiple*
Questionnaires
Reproductive Medicine*
Risk Factors
Superovulation
United States
Grant Support
ID/Acronym/Agency:
AG15425/AG/NIA NIH HHS
Comments/Corrections
Erratum In:
Obstet Gynecol 2002 Jun;99(6):1136
Note: Kontopoulos Efthica [corrected to Kontopoulos Eftichia]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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