New Policies to reduce the complications of IVF multiple births


Fertility treatments are commonly associated with multiple births. Multiple births are known to increase the risk of prematurity and lifelong complications. But the two do not have to go together. According to Yale School of Medicine researchers and their colleagues, sweeping changes can be made to policy and clinical practice which would ensure more singleton births without complications.

Improving the IVF experience in every way

Pasquale Patrizio, MD, professor in the Department of Obstetrics, Gynecology & Reproductive Sciences at Yale School of Medicine identified several changes that can reduce the odds of multiples, expand insurance coverage for in vitro fertilization and improve doctor-patient communications.

Human tendency to maximize opportunity

IVF can cost up to $10,000 for a full cycle. Because insurance covers little if any of this cost, people feel compelled to take maximum advantage of the money they are investing. Implanting multiple embryos, even with the health risks, is one way of maximizing opportunity. “Failure to cover these services causes harm to patients in addition to leading to multiple births,” explained Patrizio. “When patients are better informed of the risks of multiples, and relieved of the financial pressures, research shows that they are more likely to choose to transfer one embryo at a time.”

New policy recommendations

Patrizio and his colleagues created a research project which included fertility experts, representatives from the insurance industry and professional associations and bioethicists. They were brought together to examine causes and consequences of multiple births after fertility treatments. They recommend expanding insurance coverage to reduce financial burden and prioritize pregnancy chances. They also recommend altering the definition of an IVF cycle so that two consecutive single embryo transfers is equivalent to one double embryo transfer for calculating success and insurance benefits. Patients should be informed of the risks associated with multiples and altering policies to better enable patients to choose low-risk options.

“These policies have already been instituted in some European countries, and have resulted in a dramatic reduction in the rates of multiple births after IVF, while maintaining good live-birth rates,” concluded Patrizio.

Source: Fertility and Sterility, MedicalNewsToday


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