الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
The progress in assisted reproductive technologies has led to a tremendous success in obtaining pregnancies and deliveries in different categories of infertility but on other hand, it is associated with high incidence of multifetal pregnancies.
Multifetal pregnancies are associated with maternal and fetal risks. Materanal risks include pre-eclmpsia, postpartum hemorrhage, anemia, polyhydramnios. Low birth weight, preterm labor, miscarriage and congenital anomalies are the major fetal risks.
Prevention of iatrogenic multifetal pregnancies includes avoidance of unnecessary fertility treatment, lifestyle modification, limitation of the number of embryos transferred. In non IVF-ICSI ovarian stimulaion , prevention of multiple pregnancies can be acheived through a number of techniques as the use of the lowest doses that result in development of at least one follicle, employ a trial of clomiphene–IUI before using gonadotropins, administer human chorionic gonadotropins (hCG) earlier when fewer follicles are ready to ovulate, cancel cycles when excessive numbers of follicles develop, aspirate supernumerary follicles before administering hCG, and Switch to IVF.
In the presence of an already established multifetal pregnancy, multifetal pregnancy reduction may an option to reduce the complications by redcing the fetal number. It may be selective or non selective. It can be done through transabdominal, transcervical or transvaginal approach.
Managment of multifetal pregnancy should include hisory taking, examination , screening for anomalies and early detection and managment of fetal and maternal complications.