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Limit the number of embryos transferred in IVF, essay says

May 14, 2010 |  6:00 am

The United States should adopt a law similar to what is practiced in Sweden allowing, in most cases, only single-embryo transfers during in vitro fertilization treatment, according to an essay published Thursday in the Hastings Center Report.

SulemanBaby Infertility doctors have been urged for several years to voluntarily limit the number of embryos transferred during IVF in order to avoid multiple births, such as the famous eight babies born last year to Los Angeles resident Nadya Suleman after IVF treatment.

Studies show that success rates are still good in healthy women when only one embryo is transferred instead of two or three. But the informal policy, while reducing the rate of high-order multiples, hasn't had as much success in lowering the rate of twin births. Any birth of multiples increases the risks of complications to both the babies and mothers and significantly increases healthcare costs. Many couples would rather have twins or triplets than pay out-of-pocket for multiple single-embryo transfers to build their families, notes the author of the opinion, David Orentlicher, of the Indiana University School of Law.

That's why he suggests that the United States enact legal limits to transfer only one embryo. Double-embryo transfer could be permitted for women at low risk of multiple births or because of a woman's age or medical history. Such a law reduced multiple births in Sweden from 35% to 5%, he said in his report.

"If the outcomes were similar to those in Sweden, and if transfer restrictions were coupled with insurance coverage of IVF, the restrictions would not limit reproductive rights," Orentlicher wrote.

— Shari Roan

Photo: One of the Suleman octuplets born in January 2009. Credit: Associated Press. 

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Comments (1)

My feelings on this: I am an infertility specialist in Monterey, California. I don't want government intrusion into decisions between Physician and Patient no matter what the topic. Our legislators and their beaurocrats do not know the patient personally, and therefore, cannot make decisions for each individual. Instead, they place "general" rules affecting everyone that does not allow for the exceptions. They base their decisions on things like statistics, which is only a reflection of reality not a truth, or the greater good, which is very dependent on the current beliefs, or, worst of all, cost-benefit analysis, which takes out personal situations completely. SET is NOT ready for general consumption in the U.S. where patients are paying for their care. It requires multiple attempts just to equal the pregnancy rates of one attempt with multiple embryos, which most patients cannot afford. In addition, the average age of my patients in my last IVF cycle was 38 years old, of which several were 40 years old or more. SET in those patients would be an exercise in futility, a waste of their money, and most of all, the cause of great emotional distress. We have not perfected the means to determine the ideal embryos yet, so instituting a generalized SET requirement is like instituting a medication that only has been partially tested and/or only works partially. We don't allow that in the U.S.


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