Hanna and her Sisters

Fertility drugs, treatments raise chance of multiple births

The holiday season came early for the Treber family of Saline with the arrival of four little girls. On Oct. 1, Hanna T., Madeline A., Holly B., and Aliza I. were born in a Phoenix maternity ward.

"I was thrilled," said proud mother Sue Treber. "We were all very excited that they were going to be a part of our family."

Charles and Sue Treber are part of a growing number of parents using fertility treatments to increase their chances of conception.

Included in those who have successfully conceived children through fertility treatments are the McCaugheys of Iowa, who last week stunned the world by giving birth to the first living set of septuplets.

MARGARET MYERS/Daily Music sophomore Tabitha Treber holds her four new sisters, who were born Oct. 1. Her parents, Charles and Sue Treber, used fertility treatments to facilitate conception.

"For us, this is a very awesome thing," said Music sophomore and sister of the quadruplets Tabitha Treber. "Some people have a hard time dealing with and understanding what we've been through."

The middle names of Tabitha's sisters spell out "TABI," her nickname. Nineteen years separate Tabitha from her sisters. When she was 19, Sue Treber delivered her first daughter, and she was 38 when she gave birth to the recent four.

According to the National Center for Health Statistics, single live births rose by 17 percent, twin births by 33 percent, and triplet or higher order births increased by more than 101 percent from 1978 to 1988.

The primary factor that has led to the increase in multiple births is the more frequent use of fertility-enhancing drugs and treatments such as invitro fertilization.

"The major risk is that the fertility drug works too well and results in multiple pregnancies," said Dr. Greg Christman, assistant professor of Obstetrics/Gynecology and director of the Assisted Reproductive Technology Program at the University's Medical Center.

Multiple fetuses are in more danger than a single fetus because they are frequently born premature, which can cause developmental problems.

But premature babies often grow up perfectly healthy. The four Treber girls, born nine weeks premature, are all living at home and progressing well.

Another factor influencing the commonality of multiple births is the growing number of older women giving birth.

"The older the woman, the higher the incidence of multiple births," said obstetrics Prof. Robert Hayashi, director of Maternal-Fetal Medicine at the University's Medical Center.

Many of the women who seek fertility treatments are older and the combination of fertility drugs and age often translates into multiple births, Hayashi said.

Doctors will often advise patients with multiple fetuses to abort some of them, so the others can be more healthy in a procedure called reduction. The Trebers said they are happy they chose not to opt for a reduction.

"The rewards are so much greater than the risks," Tabitha said. "We prevented the risks. My mother went on bedrest early on and ate a lot of food."

There are two types of fertility drugs, a tablet taken orally called clomiphene citrate and an injected shot of follicle stimulating hormone, Christman said. Both drugs enhance ovulation, the production of eggs in a woman's body, and hence increase the chances of fertilization.

"One of our goals is to use all of these medications cautiously," Christman said. "A healthy pregnancy is preferably one baby."

Another option is invitro fertilization, in which eggs are removed from the woman, fertilized and placed back into the uterus. Fertility drugs are used to produce a high number of eggs in the woman, and often more than one fertilized egg is put back.

Simple chance also plays a role in the occurrence of multiple births. In the case of the Iowan septuplets, the mother received the fertility drug Pergonal. A higher dose was administered during her first pregnancy, which resulted in only one child, than her second pregnancy, when she conceived the septuplets.

The costs of giving birth to so many babies can take a financial toll on the family. In addition to the expense of the fertility treatments, hospital stays and the labor process can be exorbitant. For the birth of the Treber quadruplets, 29 doctors were present while the mother had a Caesarean section.

"Financially, it's affected us very much," Tabitha said.

Patients require different doses of the fertility drugs, depending on their ages and other factors. The task of regulating how much of a fertility drug to give a patient is left to the discretion of fertility centers.

"Obviously, our goal is to make a diagnosis and use the least risky treatments," Christman said.

Still, most doctors agree that the advent of fertility drugs has been a positive addition to the world of obstetrics.

"Fertility drugs have brought happiness to a lot of families that wouldn't have had children otherwise," Hayashi said.

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