Researchers Recommend Insurance Companies Cover Fertility Treatments To Encourage Single Embryo Transfer
September 24, 2014 – Experts Down The Hall – Ronald Feinberg
Source: Jama Pediatrics – September 15, 2014
Citing the health benefits of singleton births, researchers from Australia recommended that countries promote single embryo transfer during assisted reproductive technologies such as IVF to reduce the clinical and economic costs of multiple births.
The researchers analyzed the birth, hospital and death records of 226,624 singleton, 6,941 twin and 285 high order multiple (three or more children) infants born in West Australia between 1993 and 2003. Of these infants, 1% of singletons, 15.4% of twins and 34.7% of higher order multiples were born through assisted reproductive technology.

Twins are 18 times more likely and higher order multiples were 525 times more likely than singletons to be born preterm.
The results showed twins were 18 times more likely and higher order multiples were 525 times more likely than singletons to be born preterm. Mean hospital stays for twins and higher order multiples were 14 days and 34 days, respectively, compared to five days for singletons.
Overall, low birth weight was associated with higher cost at birth. Children born early at a weight between 3 lbs. and 5.5 lbs. incurred an average of $4,529 greater health care costs than singletons born with a typical birth weight. The researchers noted health care costs between singletons, twins and higher order multiples were similar after the first year.

From Our Expert, Dr. Ronald Feinberg
“Employers covering IVF is the most cost-effective strategy for everyone”
Most employers in the United States currently do not cover IVF in their insurance plans. However, having insurance without IVF coverage does not stop people from strongly desiring a family.
The consequences when IVF is an unmanaged and non-covered service are quite costly. When patients pursue IVF and pay out of pocket, they are more likely to insist on having multiple embryos transferred. We know through years of experience at RADfertility that transferring multiple embryos can lead to maternal and fetal health problems as well as significant short-term and long-term health care costs.
If employers covered IVF with the added incentive and requirement that all transfers involved single embryos, it would be the most cost-effective strategy for everyone. The landscape of assisted reproductive technology has shifted away from transferring multiple embryos, and we have adopted vital laboratory technologies at RADfertility within the past few years that make the goal of “one embryo, one healthy baby” a reality.
Cryopreservation, pre-implantation genetic screening (PGS), and EmbryoScope® culture are the strategies we use to identify individual embryos most likely to result in a healthy pregnancy. These three IVF laboratory measures markedly reduce the number of failed embryo transfers and pregnancy losses, which make them significant cost-saving investments in safe and effective family building.
With modern IVF technologies and higher success, we believe providing coverage for IVF while mandating single embryo transfer is the right approach for helping the most people in the U.S. overcome infertility.
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