Single-embryo IVF proves safer, but much costlier than multiple births

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In 2004, Danielle Decrette went in for in vitro fertilization. It wasn’t her first time—she and her husband had a 3-year-old daughter conceived through IVF—and she knew what she was getting into. Just as he had four years before, Decrette’s doctor stimulated her with hormones, extracted her eggs from her ovaries, fertilized them with sperm in the lab and placed the resulting embryo in her uterus. But this time the process failed. So the doctor decided to transfer two embryos in the next round to increase her odds of getting pregnant.

“You know you could have twins,” the doctor warned her before the procedure. Decrette says she “freaked out…I just wanted one more baby.” But because it seemed like her best chance at another child, she decided to do it anyway. Her twin preemies were born two months early, underweight at 3.5 pounds each, after a difficult pregnancy requiring an unusually high amount of time on bed rest.

That was 10 years ago. Today, fertility doctors would almost certainly have pushed her away from the idea of a two-embryo implant; with new techniques that make single-embryo transfers much more likely to work, the potential hazards that come with multiples are, they say, simply not worth it.

The problem, though, is that despite the industry guidelines and the clear risks of multiples, doctors and patients in the U.S. have been slow to adopt elective single-embryo transfer (eSET). In fact, last year only 12 percent of all IVF procedures in the U.S. were eSET. Many women are hesitant to do one embryo transfer at a time because of the cost savings in transferring more than one embryo at a time. For example, at the HRC Fertility clinic in Encino, California, one IVF cycle costs $7,400—below the national average of $12,400—but an additional frozen embryo transfer would cost $3,500.

Read full original article: Twins: The Fetal Paradox

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