A recent study published in the American Journal of Obstetrics and Gynecology (AJOG 2013; 209:586) documented the cost associated of healthcare expenses associated with multiple vs singleton births in the United States. The study involved a claims analysis of 437,924 deliveries of which 97.2% were singleton, 2.85% were twins, and 0.3% were triplets or more. Women with multiple births had more illnesses and complications requiring longer hospital stay than women with singleton births and their babies were much more likely to require neonatal intensive care unit admissions than singleton births. The total health care cost for singleton births was $21,458 per birth. The cost for twin births was $104,831, and the cost for high order multiple (triplet or more) births was $407,199. Therefore, pregnancies with delivery of twins cost approximately 5 times as much when compared with singleton pregnancies and pregnancies with triplets or more cost 20 times as much. The risk of multiple births in women having in vitro fertilization (IVF) is mostly due to multiple embryo transfer. That is why elective single embryo transfer (eSET) should be the standard in IVF Centers especially in women less than 35 years old. The Fertility Centers of New England has embraced strategies to minimize multiple embryo transfer including embryo culture in low Oxygen Incubators like the EmbryoScope which facilitates an elective single embryo transfer by selecting the very best single Day 5 embryo for transfer. Adopting such a strategy has enabled our patients at The Fertility Centers of New England in 2013 to achieve a 67% chance of becoming pregnant following an elective single embryo transfer.
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