Cost efficiency of reducing multiple births.

Reducing the frequency of multiple pregnancies would help to prevent prematurity associated with multiple births. Premature newborns may require extensive and costly medical interventions. Long-term disability also involves health, social and educational services during childhood, which may cost ten-fold more for twin than singleton births. On average, the known costs for twin births are four times higher than singleton births and triplet births are ten times higher than singleton births. Single embryo transfer (SET) can reduce the burden of illness due to multiple births. For good prognosis patients, the experimental evidence supports the transfer of a single embryo to reduce the burden of illness due to multiple birth and prematurity. Similar evidence suggests that the cost saving could support additional treatment cycles involving SET cycles. The findings have been confirmed by the beneficial outcome of a new health policy in Belgium, which allowed more reimbursement for assisted reproduction cycles in which transfer strategies aimed to reduce multiple birth rates.