Practitioners of In Vitro Fertilisation (IVF) needed to improve counselling on the consequences of multiple births, says an international expert calling for a greater patient education in this sector. “Most IVF practitioners do not give adequate counselling on the potentially disastrous consequences of high order multiple pregnancies,” says Dr Peter Brinsden, group medical director of Bourn Hall Clinic International. Speaking at Obs and Gyne Exhibition and Congress in Dubai, he said, “Ther has always been a belief among IVF practitioners and patients that increasing the number of embryos will improve the chances of pregnancy and patients will often choose to increase their chances with little regard to the real consequences. “The risk of foetal, neonatal and infant death is very considerably increased for twins, triplets and quadruplets. Maternal complications of triplet and high order multiple births include pregnancy induced hypertension, ante-partum and post -partum haemorrhage and severe anaemia,” he elaborated. According to Dr Brinsden, the incidence of twin and high order multiple births has quadrupled since 1980 and this increase places both mothers and babies at greater risk of complications. The increase is attributed to three major factors - women having their first child at an older age, more people resorting to ovulation induction and insemination procedures, as well as advanced fertility treatments, such as IVF. Dr Brinsden continued, “Theories about increasing the likelihood of pregnancy in accordance with the number of embryos are changing.” “Recent analyses of large databases indicate that pregnancy rates may be more influenced by the number of embryos available for transfer rather than by the number actually transferred.”