Background: Now a day, the prevalence of infertility in Iran is about 21-25 percent that is concerned in compared with global prevalence. However, the high likelihood of the implantation of transferred embryos by using assisted reproductive technology (ART) methods has led to an increase in the number of multiple pregnancies and an increased risk of several complications in fetuses and mothers, consequently. The main factors which impact in this condition are attitude and trend of decision making among infertile couples and specialists about suitable number of embryos transferred. Most of infertile couples preferred more embryos in one ART cycle because they are worried about the success rate of treatment. Many variables can affect on attitude of specialists in this issue too and sometimes just pregnancy is mentioned as a treatment. Therefore, decision making about number of embryos transferred is a controversial issues and evaluation of infertile couples and specialists attitudes and factors which influence on it, have special importance in reducing multiple pregnancies.
Methods: This study performed with 300 randomly selected infertile couples that were candid for embryo transfer with using ICSI in Avicenna Research Institute (Tehran, Iran) and specialists (80 gynecologists and 21 embryologists) who worked in ART clinics. Data gathering was done by using two questioners which are consisted 49 and 23 questions asked respectively, infertile couples and specialists’ attitude. The questions were designed on a Likert scale and the scores of the questionnaire ranged from 0-60 which were later scaled up to 100 for ease of data analysis. Accordingly, scores below 50 were considered as “negative”, 50-75 “moderate” and greater than 75 as “positive”. Data analysis was performed by SPSS software by using descriptive and non parametric statistics such as U-Mann Whitney, Kruskal Wallis, Spearman correlation coefficient and T test and regression. A P-value of <0.05 was considered significant.
Results: 57.6% and 61.8% of infertile couples didn’t have any knowledge about the success rate of pregnancy in ART methods and embryo reduction after multiple pregnancies. Most of them (49.7%) had interest in two embryos, 15.2% one, 10.2% four and 4.9% more than four embryos and most of specialists (41.6%) preferred three embryos for transferring. 9.9% of the specialists gained a score less than 50 (negative view), 67.3% between 50-75 (moderate) and 22.8% greater than 75 (positive view) and mean of scores in embryologists’ attitude (66.26±12.41) was little more than gynecologists (64.85±9.8). 57.6% of infertile couples had moderate view, 4.7% positive and 2.3% had negative view.
Conclusion: Interest of twin pregnancy among infertile couples is more. It seems that specialists preferred to transfer more embryos without any special medical condition in compared with infertile couples and embryologists have better attitude than gynecologists. Enough education about success rate of ART methods and some methods like embryo reduction are very important. It appears that the number of embryos transferred in Iranian clinics is much higher than those of the developed countries which might be due to some various factors such as quality of services, lack of comprehensive guidelines, insufficient experience of some specialists, lower chances of successful pregnancy in the absence of such measures, lack of access to skilled embryologists along with gynecologists in infertility treatment centers, lack of advanced laboratory equipment and lack of quality control in the laboratories compared to the ones in developed countries.