Even before the octuplets, there was one-at-a-time-dot-org

Posted by Marcy Darnovsky February 27, 2009
Biopolitical Times

A silver lining of the octuplets-induced media storm is the attention it's rained on efforts to reduce the numbers of twins, triplets and beyond that IVF creates. This is a goal driven by the startlingly high risks of IVF multiples for mothers and babies. It's shared by nearly all reputable fertility doctors, and endorsed by the voluntary guidelines [PDF] issued (but not enforced) by the American Society for Reproductive Medicine.

Thankfully, the trend is in the right direction. But the US still lags very far behind the countries that take a less laissez-faire approach.

Of course, in most of those countries health insurance covers the basic cost of IVF treatment, so patients feel a lot less desperate about getting pregnant on the first try. (In fact, it turns out that transferring multiple embryos barely boosts success rates, but misconceptions - so to speak - are widespread.)

The latest available US figures, for 2006, show that "single embryo transfer" - which is recommended for most women younger than 35, and which does not significantly reduce the rate of successful pregnancies - was used in only 3.3% of cycles. By contrast, single embryos are transferred in 60% of cases in Finland, and in 70% of cycles in Sweden. Unsurprisingly, that pushes twin rates way down and makes triplets very rare.

In the UK, the government agency that regulates assisted reproduction (the Human Fertilisation and Embryology Authority) recently issued rules requiring fertility clinics to reduce their multiple birth rates from the current average of 24% to 10% by 2012. And a group of British assisted reproduction experts, professional organizations, and patient groups has launched an attractive and persuasive campaign called "One at a Time." Its website about the IVF-multiples situation compiles current numbers and trends, documents the risks, and calls clearly for the remedy - the eponymous "one at a time."

Previously on Biopolitical Times: