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Single Embryo IVF Policy Would Save Money, Lives

April 15, 2011

Limiting in vitro fertilization (IVF) treatments to a single embryo transfer would save lives while dramatically reducing costs due to fewer complications from multiple births, Canadian doctors said on Thursday.

“Across Canada, there would be as many as 840 fewer babies admitted to the NICU (neonatal intensive care unit), 40 deaths avoided, 46 fewer brain injuries, and 42,400 fewer days of NICU hospitalization,” said Keith Barrington, the study’s lead author.

Dr. Barrington and colleagues from the University of Montreal reviewed information from hospital records from the neonatal intensive care unit at the Royal Victoria Hospital in Quebec, Canada.  They wanted to examine how many infants admitted to the NICU from July 2005 to July 2007 were from multiple births resulting from IVF, and how many of these infants had complications or required medical interventions.

The researchers discovered that 82 infants, or 17 percent, admitted to this NICU during the two-year period were from multiple births resulting from some form of assisted reproductive technology.

“Among these 75 babies, there were 6 deaths, 5 babies who developed a brain bleed, and 4 babies who developed a potentially blinding eye condition,” Dr. Barrington said.

Using the information obtained from the medical records, the authors calculated the estimated reduction of complications and costs if doctors administering IVF were to transfer only one embryo at a time.

“Across Canada, there would be as many as 840 fewer babies admitted to the NICU, 40 deaths avoided, 46 fewer brain injuries, and 42,400 fewer days of NICU hospitalization,” said Dr. Barrington.

Considering that each day an infant stays in the NICU costs roughly $1000, the savings would be considerable if single embryo transfers were mandatory.

Because there were roughly 20 times as many IVF procedures performed in the U.S. than in Canada in 2008, the U.S. savings would be even greater.

The researchers called for new regulations restricting the number of embryos to be transferred during IVF.  However, since IVF procedures are both costly and challenging for the mother, they advocate accompanying regulation with reimbursement of any additional costs incurred.

“Since July 2010, all of the fertility centers in Quebec have adopted this approach, and preliminary results show that twin gestation rates have dropped from 30% to 3.8%,” Dr. Barrington said.

One percent of U.S. births are a result of IVF, which results in 16 percent of twin births and 38 percent of triplets, the AFP news agency reported.

A new study will be published in an upcoming issue of The Journal of Pediatrics.

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