The number of multiple pregnancies in Spain has doubled in the last two decades , largely due to the increase in the gestational age of mothers associated with the greater use of assisted reproduction treatments. And it is that at present, most fertility clinics continue to transfer more than one embryo at a time to achieve pregnancy, increasing the probability of conceiving a multiple pregnancy by 13 times.
But the Valencian Infertility Institute (IVI) has just released a study in which it is committed to limiting the transfer to a single embryo , with the aim not only of minimizing the risks associated with multiple pregnancies, but also of saving the health system a cost estimated at more than 45 million euros on average per year.
Why have multiple pregnancies increased in Spain
In the last two decades, the age of first-time mothers has increased by more than two years , with Spain being the country with the highest percentage of women who have children aged 35 or over. This implies that in many occasions the help of reproductive medicine is needed to achieve pregnancy. Not surprisingly, according to the IVI study, “The public cost of multiple pregnancies in Spain”, 8% of pregnancies that take place in our country are achieved through assisted reproductive techniques.
Thus, and according to the latest data recorded, in 2015 Spain was the second country in Europe with the most multiple births per 1,000 pregnancies (more than 20), only below Cyprus.
More health risks and a higher healthcare cost
The IVI report refers to the increase in health risks associated with multiple pregnancies compared to single ones. These risks would occur both in the case of the mother – higher rates of abortion, pre-eclampsia, premature birth, cesarean section … and, in general, more complications during pregnancy, delivery and postpartum – and of the baby – higher rate of prematurity , low birth weight and other health problems.
Health problems in the baby associated with a multiple pregnancy would affect the National Health System, since according to the study, families would spend up to 600 additional hours (equivalent to more than 75 working days) in their care. In addition, health care in these cases would have an additional public cost of 6,300 euros.
For its part, the monitoring of the multiple pregnant woman requires greater health care, since not only does she need more follow-up appointments and pregnancy control, but by increasing the risk of cesarean section and complications after delivery, the expenses also rise, increasing 2.5 times the public cost per delivery compared to single pregnancies.
In the late 90s, fertility clinics transferred three or even more embryos in a single cycle. But little by little the trend was changing, and in the last two decades the transfer of two embryos at the same time has been the dominant practice, although more and more clinics choose to transfer a single embryo .
From IVI they firmly defend this practice and urge to carry out one-time transfers to reduce the prevalence of multiple pregnancies. This appeal was also made in 2018 by the UK College of Obstetricians and Gynecologists, after carrying out an analysis on the impact of multiple pregnancies on mothers, families, the country’s National Health System and society in general.
Transferring a single embryo does not reduce the chances of pregnancy
Although in general, couples who are undergoing assisted reproduction treatment tend to believe that they will have a greater chance of pregnancy if more than one embryo is transferred at the same time, IVI emphasizes that the studies published in this regard do not show significant differences in cumulative gestation rate with a single embryo , compared to that achieved in the transfer of two, both in cycles with own and donated gametes.
Via | IVI
In Babies and More | From First Test Tube Baby to Genetic Modification: 40 Years of Advances and Controversy in Reproductive Medicine, Twin Delivery: What You Need to Know About Multiple Births
