Psychosocial risks associated with multiple births resulting from assisted reproduction: a Spanish sample

Objective: To determine the psychosocial risks associated with multiple births (twins or triplets) resulting from assisted reproductive technology (ART). Design: Transverse study. Setting: Infertility units of a university hospital and a private hospital. Patient(s): Mothers and fathers of children between 6 months and 4 years conceived by ART (n = 123). The sample was divided into three groups: parents of singletons (n = 77), twins (n = 37), and triplets (n = 9). Intervention(s): The questionnaire was self-administered by patients. It was either completed at the hospital or mailed to participants' homes. Main Outcome Measure(s): Scales measured material needs, quality of life, social stigma, depression, stress, and marital satisfaction. Result(s): Logistic regression models were applied. Significant odds ratios were obtained for the number of children, material needs, social stigma, quality of life, and marital satisfaction. The results were more significant for data provided by mothers than by fathers. Conclusion(s): The informed consent form handed out at the beginning of ART should include information on the high risk of conceiving twins and triplets and on the possible psychosocial consequences of multiple births. As soon as a multiple pregnancy is confirmed. it would be useful to provide information on support groups and institutions. Psychological advice should also be given to the parents. (Fertil Steril (R) 2009:92:1059-66. (C)2009 by American Society for Reproductive Medicine.)