FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia VelascoPrevention of multiple pregnancies in gonadotropin-insemination cyclesDahdouh, Elias M.a,b; Zreik, Tony G.c; Ghaname, Wadihc; Garcia-Velasco, Juan A.d; Balayla, Jacquese Author Information aDepartment of Obstetrics and Gynecology, Assisted Reproduction Technology Centre, CHU Sainte-Justine bDivision of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Université de Montréal, Montreal, Quebec, Canada cDepartment of Obstetrics and Gynecology, Gilbert & Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon dIVI-RMA, and the Department of Obstetrics and Gynecology, Rey Juan Carlos University, Madrid, Spain eDepartment of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada Correspondence to Elias M. Dahdouh, ART Centre, CHU Sainte-Justine, 3175 Chemin de la Cote-Sainte-Catherine, Montreal, QC, Canada H3T1C5. Tel: +1 514 345 4931; e-mail: [email protected] Current Opinion in Obstetrics and Gynecology: June 2022 - Volume 34 - Issue 3 - p 101-106 doi: 10.1097/GCO.0000000000000777 Buy Metrics Abstract Purpose of review Although elective single embryo transfer has significantly reduced, the rate of multiple pregnancy in IVF cycles, this rate is still relatively high in gonadotropin-insemination cycles. Patients who fail to ovulate or to conceive with oral agents and have constraints for IVF are usually candidates for gonadotropin injections. The current review article provides an up-to-date summation of the different strategies that can be adopted to reduce the risk of multiple pregnancies in gonadotropin-stimulated intrauterine insemination cycles. Recent findings Gonadotropin-insemination treatments should be used judiciously by experienced providers. One should always start with the lowest effective gonadotropin dose (∼37.5 IU), monitor closely the ovarian response, and consider cycle cancellation or conversion to IVF whenever a high response is encountered. Therefore, every infertility practice should define its own cancellation and ‘rescue IVF’ criteria depending on the number of mature ovarian follicles and the age of the female partner. Summary These preventive measures amongst others should mitigate the risk of multiple pregnancies that can arise from gonadotropin-insemination cycles. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.