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In the last twenty years, the number of multiple pregnancies in our country has doubled, motivated, in large part, by the increase in the gestation age of women. In 2018, the median age of new mothers was 31. These women, on many occasions, have to resort to reproductive medicine, in which the transfer of a single embryo is seldom chosen, a practice of which IVI is the maximum defender.
We have always talked to you about medical reasons, which there are and many, to avoid multiple pregnancies, but today, and thanks to a report prepared jointly with the consulting firm Deloitte, we can also say that the transfer of a single embryo could save the State more than 45 million euros of average per year.
Increase in pregnancies thanks to reproductive medicine
Our country has the highest percentage of women who are mothers aged 35 or over, a figure that has grown in recent years. This fact implies needing the help of reproductive medicine to conceive, which represents an increase of 275% of pregnancies through assisted reproduction treatments in the last ten years. Therefore, these types of pregnancies represent 8% of the total, five times more than a decade ago.
“Current assisted reproduction practices in Spain continue to rely on the transfer of more than one embryo at a time to achieve gestation –more than 50% of the cycles in the private sector and 70% of the cycles in the public sector– . The scientific evidence is clear on this issue: multiple pregnancies negatively impact the health of mothers, for example, with a risk up to five times higher for pre-eclampsia; and in that of newborns, particularly increasing the risk of adverse health events such as the probability of low birth weight, prematurity or pathologies that may affect the different organs of the baby ”, explains Dr. Antonio Requena, IVI’s medical director.
Single embryo transfer
Dr. Requena adds: “In this situation, actions can be taken to limit health risks for mothers, newborns and their families, starting with a change in assisted reproduction practices. As an example, the transfer of a single embryo could be promoted which, in addition to reducing the number of multiple pregnancies and the associated health risks, could save the state more than 45 million euros on average per year “.
Women and couples with reproductive problems trust the belief that by transferring more than one embryo they will have a better chance of pregnancy. But the reality, published in several studies, is that there are no significant differences in the cumulative pregnancy rate with a single embryo compared to that achieved in the transfer of two, both in cycles with own and donated gametes.
The reason for the transfer of a single embryo
What Dr. Requena comments is one of the most important conclusions that are gathered in a report, recently published, carried out by IVI together with the consulting firm Deloitte. It is the first study on “The public cost of multiple pregnancies in Spain”, a pioneering research in Spain, in which the implication of IVI in patient safety and well-being in society is revealed.
Single embryo transfer could reduce the number of multiple pregnancies by up to 3,400, or 50%, by decreasing, for example:
- 500 miscarriages, fetal deaths and neonatal deaths
- 400 caesarean sections
- 500 premature births
- 700 neonatal admissions
“This report explores the evolution of multiple pregnancies in Spain and quantifies the public cost associated with these with respect to single pregnancies. This makes it possible to evaluate the net benefits that would result from changes in assisted reproduction practices –among them, reducing both the health risks that affect mothers and families and the public spending that affects the Spanish welfare state– “, adds Dr. Antonio Requena.
Risks of transferring more than one embryo
As this study shows, these health risks mean that families suffer more difficult pregnancies, also during childbirth and postpartum. The report concludes that, from gestation to three years of life of the babies, these families will need 600 overtime hours – which is equivalent to more than 75 working days or a third of the working year – in contact with the National Health System and at home, caring for newborns with health problems.
This high health risk due to multiple pregnancies also entails greater medical assistance and social benefits, which can translate into a public cost 2.5 times higher or more than € 14,300 additional for multiple births compared to simple deliveries. You can consult the complete study on “the public cost of pregnancies in Spain”.
75% reduction in multiple pregnancies in IVI
IVI’s firm commitment to the reduction of multiple pregnancies is already a reality in our clinics where, currently, in more than 90% of cases a single embryo transfer (SET, for its acronym in Spanish) is performed. English). In the last ten years we have managed to reduce this type of pregnancies by 75%, increasing the chances of a healthy baby at term.
Added to this figure is the current rate of twins, which barely reaches 4%, at the same level as the national rate of twins conceived naturally, which is 2.4%, according to the Centers for Disease Control and Prevention. (CDC, for its acronym in English).
“The reason why this strategy has been implemented for almost 100% of our treatments is because we know the best mechanisms that regulate endometrial receptivity, techniques such as Timelapse, which allow us to see the evolution of the embryo, or improvements in embryo selection thanks to pre-implantation genetic diagnosis, to rule out embryos with chromosomal abnormalities. All this complemented by the educational work of both medical professionals and the population so that it is understood that multiple gestation is not an objective to be achieved, but rather a complication to avoid “, concludes Dr. Requena.
