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During the 20 years since the first child was born in Sweden after in vitro fertilisation, clinical policy has changed. During the early 1990s, the clinics performing in vitro fertilisation and the National Board of Health and Welfare agreed to reduce the number of embryos transferred to the uterus during in vitro fer- tilisation from three to two. Here, we describe the changes in multiple birth rates that have resulted from this change and their impact on the rate of preterm birth. In future papers we intend to describe maternal and child characteristics in greater detail. Participants, methods, and results In Sweden 17 hospitals or private clinics perform in vitro fertili- sation. The National Board of Health and Welfare requested information from these laboratories on all women who had undergone in vitro fertilisation and who had had a baby or whose pregnancy outcome was not known. By linking these data with the Swedish medical birth register, we identified infants born from 1982 to 2001. 12

Temporal trends in multiple births after in vitro fertilisation in Sweden, 1982-2001: a register study