Thanks to Dr. Barbieri for taking a stand on the “non-sense” that has become common practice for some practitioners of reproductive endocrinology: the implantation of multiple (more than 2) embryos. Though it can be truly rewarding and joyous to help an IVF patient conceive, these pregnancies contribute significantly to the incidence of premature births, neurodevelopmental disorders, chronic lung disease, deafness and blindness, infant mortality, and long-term behavioral abnormalities.
We must remember the admonition to “do no harm.” In my opinion, the creation of higher-order multiple gestations as a consequence of infertility care is inappropriate.
Dr. Barbieri, I couldn’t agree more with your editorial—though I do think you were actually too kind.
Jordan H. Perlow, MD
Dr. Barbieri responds:
I thank Drs. Chen, Robinson, and Perlow for their thoughtful comments and deep commitment to trying to identify a constructive approach to the complex and common problem of multiple gestations resulting from fertility treatments. From my perspective, our field needs to try harder to mobilize experienced ObGyn clinicians such as them to help solve this problem.