Judy Peres and the Tribune are to be commended for the two recent articles regarding the assisted reproductive technologies and the many difficult issues they raise (News, July 21 and Perspective, July 26).
One very important point, however, deserves clarification. Many readers might have inferred from these pieces that the multiple-birth problem primarily is related to the in-vitro fertilization process, or IVF. The patients who are in fact at highest risk for multiple gestations, particularly those beyond twins, are those who are treated with injectable medications such as Pergonal or Humagon but without IVF. These patients generally have either ovulation problems or unexplained infertility. The woman in Iowa who gave birth to septuplets was such a patient.
Those of us who take care of couples suffering from infertility are hopeful that, within a few years, the IVF process will be efficient enough to achieve a high pregnancy rate with the transfer of only one or two embryos.
At this point the use of the injectable medicines alone, particularly for couples with unexplained infertility, could largely be eliminated. This will bring us much closer to resolving the multiple-birth issue.
