Abstract
The number of infants born premature and low birth weight as a result of multiple birth via IVF is too high. Multiple gestation, including twins, poses serious health risks to both mothers and babies. They disproportionately contribute to infant and maternal morbidity and mortality rates. The true societal costs of these births are unknown but are likely to be significant when you add together the obstetric, neonatal and long-term rehabilitative and educational costs associated with caring for multiples. Neither professional guidelines, nor government regulations have sufficiently addressed this issue. In this thesis I provide a comprehensive review of the problem and assess options for minimizing the number of embryos transferred in each IVF cycle thereby lessening the high multiple birth rate. Conclusions Reached Using a Criteria-Alternative Matrix helped me to reach the conclusion that the best alternative at this time is to require a mandatory direct and sustained campaign of improved education directed to fertility patients on the levels and preponderance of the risks of multiples. It is important to note that the financial burden of paying for IVF coupled with the low success rates are likely the most important factors in embryo transfer choice. Working towards additional insurance coverage of IVF would result in less multiples being born and as a result greater healthcare cost savings.