Aspirantskiy Vestnik PovolzhiyaAspirantskiy Vestnik Povolzhiya2072-23542410-3764Samara State Medical University2531710.17816/2072-2354.2018.18.3.65-70Research ArticleTHE EXPERIENCE OF REDUCING THE INDEX OF MULTIPLE PREGNANCIES IN THE IVF AND ICSI PROGRAMSSaraevaN VObstetrician of IDK Medical Company, group of the companies “Mother and Child”, Samara, Postgraduate student, Obstetrics and Gynecology Department of IPE, Samara State Medical University.kuzichkina@gmail.comSpiridonovaN VDoctor of Medicine, Professor, Head of the Obstetrics and Gynecology Department, IPE, Samara State Medical University.nvspiridonova@mail.ruTugushevM TChief Physician of IDK Medical Company, group of the companies “Mother and Child”, Samara, Candidate of Medicine, Head of the Department of Reproductive Medicine, Clinical Embryology and Genetics, Samara State Medical University.m.tugushev@yahoo.comShuryginaO VDoctor of Medicine, Professor, Histology and Embryology Department, Samara State Medical Universityoks-shurygina@yandex.ru“Medical Сompany IDK”, Group of Companies “Mother and Child”Samara State Medical University15092018185-6657011032020Copyright © 2018, Saraeva N.V., Spiridonova N.V., Tugushev M.T., Shurygina O.V.2018The article presents the experience of the ART clinic in reducing the index of multiple pregnancy after the IVF, the IVF + ICSI programs. The decrease in the share of cycles with two embryos transfer on the 2 and 3 days of development and increasing in the share of cycles with one blastocyst transfer led to decrease of the multiple pregnancies rate in the clinic from 29% in 2006 to 6% in 2017. It is shown that one blastocyst transfer reduces the multiple pregnancy rate without a significant reduction in the overall clinical pregnancy rate. With reference to the performed analysis the algorithm of selecting of the day of embryo transfer and the number of embryos transferred embryos was developed.assisted reproductive technologymultiple pregnancysingle embryo transferelective single embryo transferвспомогательные репродуктивные технологиимногоплодная беременностьперенос одного эмбрионаэлективный перенос одного эмбриона[Калинкина О.Б., Спиридонова Н.В., Юнусова Ю.Р., Аравина О.Р. Многофакторный анализ риска развития акушерских и перинатальных осложнений у пациенток с ожирением и избыточной массой тела // Известия Самарского научного центра РАН. - 2015. - Т. 17. - № 5-3. - С. 793-797][Кузичкина (Сараева) Н.В., Пекарев В.А., Краснова О.В, Пастухова Е.А. К вопросу о снижении частоты многоплодной беременности / Материалы XVI международной конференции Российской Ассоциации Репродукции Человека; Ростов-на-Дону, 7-9 сентября 2006 г. - Ростов-на-Дону, 2006. - С. 31][Линева О.И., Шляпников М.Е., Спиридонова Н.В. Пути решения научных аспектов проблемы охраны репродуктивного здоровья семьи в регионе // Самарский медицинский журнал. - 2008. - Т. 4-5. - № 15. - С. 55][Сараева Н.В., О.В. Шурыгина, Пекарев В.А. Многоплодная беременность в программах ВРТ: путь от количества к качеству / Материалы XXV юбилейной международной конференции Российской ассоциации репродукции человека; Сочи, 9-12 cентября 2015 г. - Сочи, 2015. - С. 221][Anderson P, Doyle LW, Victorian Infant Collaborative Study G. Neurobehavioral outcomes of school-age children born extremely low birth weight or very preterm in the 1990s. JAMA. 2003;289(24):3264-3272. doi: 10.1001/jama.289.24.3264][De Sutter P, Van der Elst J, Coetsier T, Dhont M. Single embryo transfer and multiple pregnancy rate reduction in IVF/ICSI: a 5-year appraisal. Reprod Biomed Online. 2003;6(4):464-469][Gardner DK, Meseguer M, Rubio C, Treff NR. Diagnosis of human preimplantation embryo viability. Hum Reprod Update. 2015;21(6):727-747. doi: 10.1093/humupd/dmu064][Kissin DM, Kulkarni AD, Mneimneh A, et al. Embryo transfer practices and multiple births resulting from assisted reproductive technology: an opportunity for prevention. Fertil Steril. 2015;103(4):954-961. doi: 10.1016/j.fertnstert.2014.12.127][Land JA, Evers JL. Risks and complications in assisted reproduction techniques: Report of an ESHRE consensus meeting. Hum Reprod. 2003;18(2):455-457. doi: 10.1093/humrep/deg081][Min JK, Breheny SA, MacLachlan V, Healy DL. What is the most relevant standard of success in assisted reproduction? The singleton, term gestation, live birth rate per cycle initiated: the BESST endpoint for assisted reproduction. Hum Reprod. 2004;19(1):3-7. doi: 10.1093/humrep/deh028][Kim MS, Kim JH, Jee BC, et al. Factors affecting occurrence of twin pregnancy after double embryo transfer on day 3. J Obstet Gynaecol Res. 2015;41(8):1223-1228. doi: 10.1111/jog.12687][Ombelet W, De Sutter P, Van der Elst J, Martens G. Multiple gestation and infertility treatment: registration, reflection, and reaction - the Belgian project. Hum Reprod Update. 2005;11(1):3-14. doi: 10.1093/humupd/dmh048][Practice Committee of Society for Assisted Reproductive Technology, and Practice Committee of American Society for Reproductive Medicine. Elective single-embryo transfer. Fertil Steril. 2012;97(4):835-842. doi: 10.1016/j.fertnstert.2011.11.050][Templeton A. IVF success rates - the importance of data presentation. Reprod Biomed Online. 2003;7(Suppl 2):14-16][Thurin A, Hausken J, Hillensjo T, et al. Elective single-embryo transfer versus double-embryo transfer in in vitro fertilization. N Engl J Med. 2004;351(23):2392-2402. doi: 10.1056/NEJMoa041032][Tiitinen A, Unkila-Kallio L, Halttunen M, Hyden-Granskog C. Impact of elective single embryo transfer on the twin pregnancy rate. Hum Reprod. 2003;18(7):1449-1453. doi: 10.1093/humrep/deg301]