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MeSH Review

Pregnancy, Multiple

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Disease relevance of Pregnancy, Multiple


Psychiatry related information on Pregnancy, Multiple

  • CONCLUSION(S): Over the years, ART therapies have steadily become more effective, with notable reductions in multiple pregnancies, the ability to avoid laparoscopy (for egg retrieval and in some cases tubal transfers), and effective therapy for serious sperm, egg, and uterine problems, none of which was true in the early years [6].

High impact information on Pregnancy, Multiple

  • However, increasing total numbers of follicles and increasing peak serum estradiol concentrations correlated significantly with an increasing risk of high-order multiple pregnancy (P<0.001), as did younger age (P=0.008) [7].
  • Preservation of embryos for a limited time allows fewer embryos to be replaced on several different occasions and thus the problems of multiple pregnancy can be minimized, the effectiveness of a single IVF procedure increased and embryo replacement in adverse maternal conditions avoided [8].
  • The pregnancy and multiple pregnancy rates after stimulation with clomiphene alone or with human menopausal gonadotropin were comparable, but oocyte pickup based on a knowledge of the duration of the endogenous rise in luteinising hormone, rather than 36 h after administration of human chorionic gonadotropin, increased the pregnancy rate [9].
  • Moreover, there is an increasing trend to culture embryos for longer periods of time before uterine transfer to identify the "best" embryos for transfer and to minimize multiple pregnancies [10].
  • Since pRb-deficiency results in embryonic lethality, we transplanted pRb-null mammary anlagen into wild hosts. pRb-deficient mammary epithelia were capable of functional differentiation in term animals and they regenerated a differentiated gland even after multiple pregnancies [11].

Chemical compound and disease context of Pregnancy, Multiple


Biological context of Pregnancy, Multiple


Anatomical context of Pregnancy, Multiple


Associations of Pregnancy, Multiple with chemical compounds


Gene context of Pregnancy, Multiple

  • Plasma POMC was significantly higher in multiple pregnancies with very high levels in three triplet-bearing mothers: 671, 941, and 1731 U/ml at 31, 33 and 32 weeks, respectively [31].
  • OBJECTIVE: We tested the hypothesis that multiple pregnancies would be associated with altered expression of the following three groups of proteins that are key regulators of myometrial function: (i) Gsalpha, (ii) connexins-43 and 26, and (iii) prostanoid EP1, EP3, and EP4 receptors [32].
  • No similar stagnation of endometrial thickness and no effects of mid-cycle HCG administration on endometrial thickness, the implantation rate and the number of multiple pregnancies were found in women with high endogenous LH [33].
  • PHA treatment cycles were characterized by the reestablishment of a normal endocrine pattern, almost no dose-related endocrine differences, elevated ovulatory (93%) and conception rates (23%), and no multiple pregnancies [34].
  • Implantation (gestational sacs/embryo transferred) and multiple pregnancy (multiple gestations/ pregnant recipient) rates were slightly higher in relaxin-treated recipients compared to vehicle-treated recipients [35].

Analytical, diagnostic and therapeutic context of Pregnancy, Multiple


  1. Successful induction of ovulation in normogonadotrophic clomiphene resistant anovulatory women by combined naltrexone and clomiphene citrate treatment. Roozenburg, B.J., van Dessel, H.J., Evers, J.L., Bots, R.S. Hum. Reprod. (1997) [Pubmed]
  2. Treatment of anovulatory infertility: the problem of multiple pregnancy. Farhi, J., West, C., Patel, A., Jacobs, H.S. Hum. Reprod. (1996) [Pubmed]
  3. Polycystic ovary syndrome: abnormalities and management with pulsatile gonadotropin-releasing hormone and gonadotropin-releasing hormone analogs. Filicori, M., Flamigni, C., Campaniello, E., Meriggiola, M.C., Michelacci, L., Valdiserri, A., Ferrari, P. Am. J. Obstet. Gynecol. (1990) [Pubmed]
  4. Tape measurement of symphysis-fundal height in twin pregnancies. Neilson, J.P., Verkuyl, D.A., Bannerman, C. British journal of obstetrics and gynaecology. (1988) [Pubmed]
  5. Recurrent ACTH-independent Cushing's syndrome in multiple pregnancies and its treatment with metyrapone. Hána, V., Dokoupilová, M., Marek, J., Plavka, R. Clin. Endocrinol. (Oxf) (2001) [Pubmed]
  6. Progress we can be proud of: U.S. trends in assisted reproduction over the first 20 years. Toner, J.P. Fertil. Steril. (2002) [Pubmed]
  7. Reducing the risk of high-order multiple pregnancy after ovarian stimulation with gonadotropins. Gleicher, N., Oleske, D.M., Tur-Kaspa, I., Vidali, A., Karande, V. N. Engl. J. Med. (2000) [Pubmed]
  8. Human pregnancy following cryopreservation, thawing and transfer of an eight-cell embryo. Trounson, A., Mohr, L. Nature (1983) [Pubmed]
  9. Incidence of multiple pregnancy after in-vitro fertilisation and embryo transfer. Kerin, J.F., Warnes, G.M., Quinn, P.J., Jeffrey, R., Kirby, C., Matthews, C.D., Seamark, R.F., Cox, L.W. Lancet (1983) [Pubmed]
  10. Long-term effects of culture of preimplantation mouse embryos on behavior. Ecker, D.J., Stein, P., Xu, Z., Williams, C.J., Kopf, G.S., Bilker, W.B., Abel, T., Schultz, R.M. Proc. Natl. Acad. Sci. U.S.A. (2004) [Pubmed]
  11. Functional mammary gland development and oncogene-induced tumor formation are not affected by the absence of the retinoblastoma gene. Robinson, G.W., Wagner, K.U., Hennighausen, L. Oncogene (2001) [Pubmed]
  12. Ritodrine and nifedipine as tocolytic agents: a preliminary comparison. van Dijk, K.G., Dekker, G.A., van Geijn, H.P. Journal of perinatal medicine. (1995) [Pubmed]
  13. Epidural anaesthesia for caesarean delivery in triple and quadruple pregnancies. Behforouz, N., Dounas, M., Benhamou, D. Acta anaesthesiologica Scandinavica. (1998) [Pubmed]
  14. The Bristol third stage trial: active versus physiological management of third stage of labour. Prendiville, W.J., Harding, J.E., Elbourne, D.R., Stirrat, G.M. BMJ (1988) [Pubmed]
  15. Higher-order multiple pregnancy associated with metformin in women with polycystic ovary syndrome: two cases and review of the literature. Boothroyd, C., Yazdani, A. Fertil. Steril. (2006) [Pubmed]
  16. Emerging drugs in assisted reproduction. Papanikolaou, E.G., Kolibianakis, E., Devroey, P. Expert opinion on emerging drugs. (2005) [Pubmed]
  17. Low multiple pregnancy rate in combined clomiphene citrate--human menopausal gonadotrophin treatment for ovulation induction or enhancement. Ron-el, R., Soffer, Y., Langer, R., Herman, A., Weintraub, Z., Caspi, E. Hum. Reprod. (1989) [Pubmed]
  18. Number of embryos for transfer after IVF and ICSI: a Cochrane review. Pandian, Z., Templeton, A., Serour, G., Bhattacharya, S. Hum. Reprod. (2005) [Pubmed]
  19. Low-dose gonadotrophin therapy for induction of ovulation in 100 women with polycystic ovary syndrome. Hamilton-Fairley, D., Kiddy, D., Watson, H., Sagle, M., Franks, S. Hum. Reprod. (1991) [Pubmed]
  20. Spontaneous embryonic loss after in vitro fertilization with and without intracytoplasmic sperm injection. La Sala, G.B., Nucera, G., Gallinelli, A., Nicoli, A., Villani, M.T., Blickstein, I. Fertil. Steril. (2004) [Pubmed]
  21. Hyperstimulation: the need for cryopreservation of embryos. Van den Abbeel, E., Van der Elst, J., Van Waesberghe, L., Camus, M., Devroey, P., Khan, I., Smitz, J., Staessen, C., Wisanto, A., Van Steirteghem, A. Hum. Reprod. (1988) [Pubmed]
  22. Is blastocyst transfer useful as an alternative treatment for patients with multiple in vitro fertilization failures? Cruz, J.R., Dubey, A.K., Patel, J., Peak, D., Hartog, B., Gindoff, P.R. Fertil. Steril. (1999) [Pubmed]
  23. Selective oocyte retrieval: a new approach to ovarian hyperstimulation. Belaisch-Allart, J., Belaisch, J., Hazout, A., Testart, J., Frydman, R. Fertil. Steril. (1988) [Pubmed]
  24. Number of transferred embryos: how to reduce multiple pregnancies. Germond, M., Primi, M.P., Urner, F., Chanson, A., Wirthner, D., Senn, A. Ann. N. Y. Acad. Sci. (2004) [Pubmed]
  25. Serum alphafetoprotein in multiple pregnancy. Bryan, E.M., Thorp, R.W., Nicholson, E. Biol. Neonate (1978) [Pubmed]
  26. Review: aromatase inhibitors for ovulation induction. Casper, R.F., Mitwally, M.F. J. Clin. Endocrinol. Metab. (2006) [Pubmed]
  27. Gestational glucose intolerance in multiple pregnancy. Corrado, F., Caputo, F., Facciolà, G., Mancuso, A. Diabetes Care (2003) [Pubmed]
  28. Mechanical stretch activates type 2 cyclooxygenase via activator protein-1 transcription factor in human myometrial cells. Sooranna, S.R., Lee, Y., Kim, L.U., Mohan, A.R., Bennett, P.R., Johnson, M.R. Mol. Hum. Reprod. (2004) [Pubmed]
  29. Ovulation induction with subcutaneous pulsatile gonadotropin-releasing hormone: singleton pregnancies in patients with previous multiple pregnancies after gonadotropin therapy. Hurley, D.M., Brian, R.J., Burger, H.G. Fertil. Steril. (1983) [Pubmed]
  30. Maternal plasma levels of human chorionic gonadotrophin, oestradiol and progesterone in multifetal pregnancies before and after fetal reduction. Johnson, M.R., Abbas, A., Nicolaides, K.H. J. Endocrinol. (1994) [Pubmed]
  31. High precursor level in maternal blood results from the alternate mode of proopiomelanocortin processing in human placenta. Raffin-Sanson, M.L., Massias, J.F., Ankotche, A., Coste, J., de Keyzer, Y., Oliver, C., Dumont, C., Cabrol, D., Ferré, F., Bertagna, X. Clin. Endocrinol. (Oxf) (1999) [Pubmed]
  32. Expression of Gsalpha, connexin-43, connexin-26, and EP1, 3, and 4 receptors in myometrium of prelabor singleton versus multiple gestations and the effects of mechanical stretch and steroids on Gsalpha. Lyall, F., Lye, S., Teoh, T., Cousins, F., Milligan, G., Robson, S. J. Soc. Gynecol. Investig. (2002) [Pubmed]
  33. Luteinizing hormone affects uterine receptivity independently of ovarian function. Tesarik, J., Hazout, A., Mendoza, C. Reprod. Biomed. Online (2003) [Pubmed]
  34. Endocrine response determines the clinical outcome of pulsatile gonadotropin-releasing hormone ovulation induction in different ovulatory disorders. Filicori, M., Flamigni, C., Meriggiola, M.C., Ferrari, P., Michelacci, L., Campaniello, E., Valdiserri, A., Cognigni, G. J. Clin. Endocrinol. Metab. (1991) [Pubmed]
  35. Implantation and pregnancy following in vitro fertilization and the effect of recombinant human relaxin administration in Macaca fascicularis. Hayes, E.S., Curnow, E.C., Trounson, A.O., Danielson, L.A., Unemori, E.N. Biol. Reprod. (2004) [Pubmed]
  36. Would legislation imposing single embryo transfer be a feasible way to reduce the rate of multiple pregnancies after IVF treatment? Saldeen, P., Sundström, P. Hum. Reprod. (2005) [Pubmed]
  37. Cumulative conception and live birth rates in natural (unstimulated) IVF cycles. Nargund, G., Waterstone, J., Bland, J., Philips, Z., Parsons, J., Campbell, S. Hum. Reprod. (2001) [Pubmed]
  38. Improved pregnancy outcome with the addition of leuprolide acetate to gonadotropins for in vitro fertilization. Chetkowski, R.J., Kruse, L.R., Nass, T.E. Fertil. Steril. (1989) [Pubmed]
  39. Avoiding multiple pregnancies in ART: consideration of new strategies. Hazekamp, J., Bergh, C., Wennerholm, U.B., Hovatta, O., Karlström, P.O., Selbing, A. Hum. Reprod. (2000) [Pubmed]
  40. Algorithm to predict assisted reproductive technology pregnancy outcome reveals minimal embryo synergy. Torsky, S.P., Amato, P., Cisneros, P.L., Sangi-Haghpeykar, H., Trukhacheva, E.V., Carson, S.A. Fertil. Steril. (2005) [Pubmed]
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