Fertility Drugs, not IVF, Are Top Cause of Multiple Births
When I spoke in New Zealand, I learned that the country’s national health service pays for two rounds of in vitro fertilization (IVF), each time implanting a single embryo. A recent report by Nancy Shute for NPR reveals some fascinating findings. She writes that a study published in the New England Journal of Medicine relates that drugs such as Clomid and injectable hormones account for the largest percentage of triplets and higher-order multiples in the United States. Fertility drugs are cheaper and easier to use than IVF and are often covered by insurance. Between 1998 and 2011, multiple births attributable to IVF dropped from 48 percent to 32 percent. Since 1998, doctors have discouraged women from transferring more than two embryos at a time for IVF. Improved IVF techniques have made it more likely to achieve a successful single birth by transferring one embryo and are credited with lowering the number of higher-order multiples by 29 percent from 1998 to 2011.
However, the main author of the article, Dr. Eli Adashi, affirms that not all fertility doctors are using lower dosages of drugs, which would help reduce the number of multiples. And many couples dismiss their fertility doctor’s message about the complications of a twin pregnancy and insist on two embryos to boost their chances of conception as well as to complete their family in one shot. They are often unrealistic about the challenges of raising two children at the same time and blindsided by the expectable loving relationship that twins are destined to share.
I am sympathetic to couples who have struggled with infertility and desperately want a family. Nonetheless, in most cases, I feel that it is healthier to have one child at a time than to have a multiple birth. Given our access to better technology, implanting one embryo seems the most advantageous for the parents as well as the child in terms of time, resources, and physical and emotional health.
What do you think?