Selective embryo reduction in multiple pregnancies resulting from assisted conception.

BACKGROUND: Assisted conception not only raises the pregnancy rate by treating infertility, but also increases the chance of obstetrical complication of multiple pregnancy. So it is important to develop a means by which the number of developing embryos can be reduced. METHODS: Eight multiply pregnant women (from triplets to octuplets) asked to have the number of viable fetuses reduced. By means of sonar guided puncture, a mixture of demerol and xylocaine was injected to the fetal thorax until the fetal heart ceased to beat. The procedures were done between the 7th and 11th week of gestational age. Repeated scans were done for three consecutive days to confirm the viability of the remaining fetuses. RESULTS: Except for vanishing twins, no serious complication was noted. For six of the women, 10 healthy births have resulted; the remaining two have ongoing pregnancies. CONCLUSIONS: The procedure described is an easy, safe and effective method to diminish obstetrical morbidity of multiple pregnancy.