Is single embryo or multiple embryo transfer better? That is the question on the minds of many couples trying to conceive. For many couples multiple-transfer gives them the best odds of conception and lowest upfront costs. For others a single embryo transfer provides similar odds of conception without the hidden costs associated with multiple pregnancies. A few lucky couples will find that single embryo transfer is the best overall option, while the remainder must roll the dice on a multiple transfer. Multiple transfers have greater odds of multiple pregnancies, and multiple pregnancies come with many risks and hidden costs. This article will explore some of these hidden costs.
A Few Lucky Couples
A few lucky couples will fall into the category where a single embryo transfer is the clear winner. Couples who are very healthy, and can produce at least one high quality embryo may find that single embryo transfer provides similar odds of conception without the downside risks. Multiple embryos are often transferred to increase the odds of conception for any single round of IVF, but it also increases the odds of a multiple pregnancy. Multiple pregnancies have higher risks and hidden costs, so any approach that maintain a high pregnancy rate while minimizing risks and costs should be pursued.
Risk of Multiple Pregnancies
Multiple pregnancies present higher health risks for mothers and babies. A variety of complications common to pregnancy occur more frequently with multiple pregnancies. An incompetent cervix is more likely due to the increased pressure. Placenta previa is more common in multiple pregnancies due to number and size of placentas present. The majority of women pregnant with multiples eventually develop iron-deficiency anemia. Mothers of multiples develop gestational diabetes two or three times more often than those with single pregnancies. Preeclampsia occurs in about ten percent of single pregnancies, while it occurs in nearly one third of multiple pregnancies. Pre term labor occurs in approximately 50% of twins, and 90% of triplets.
Hidden Costs of Multiple Pregnancies
When evaluating whether to transfer a single embryo or multiple embryos a couple can easily determine their upfront costs. If they have insurance that covers IVF they probably research what their out-of-pocket costs will be. Most couples have no such coverage, so they may know these upfront costs very well. And the biggest determining factor in the cost of getting pregnant via IVF is the number of cycles required. Multiple transfers may lower the need for multiple cycles and lower upfront costs.
But what about the costs associated with multiple pregnancies? Many of these costs are hidden. Unfortunately couples must find out the hard way, only after depleting savings or taking on debt to get pregnant in the first place.
Some hidden costs might include mom's lost income if she experiences one of the more common pregnancy complications associated with a multiple pregnancy. A normal pregnancy last for nine months. What if complications arise in the first month and your doctor orders immediate bed rest?
Pre term labor is very common with multiples as described above. Pre term babies are often confined to a Neonatal Intensive Care Unit (NICU). Many insurance plans contain a hospital deductible or co-pay that may be then applied to each child confined. Premature infants are at a higher risk of hearing loss, vision problems, and developmental delays. Many diagnostic tests are not covered by insurance, and an extremely sick infant may require one or both parents to take an extended unpaid family medical leave.
A Few Lucky Couples
A few lucky couples will fall into the category where a single embryo transfer is the clear winner. Couples who are very healthy, and can produce at least one high quality embryo may find that single embryo transfer provides similar odds of conception without the downside risks. Multiple embryos are often transferred to increase the odds of conception for any single round of IVF, but it also increases the odds of a multiple pregnancy. Multiple pregnancies have higher risks and hidden costs, so any approach that maintain a high pregnancy rate while minimizing risks and costs should be pursued.
Risk of Multiple Pregnancies
Multiple pregnancies present higher health risks for mothers and babies. A variety of complications common to pregnancy occur more frequently with multiple pregnancies. An incompetent cervix is more likely due to the increased pressure. Placenta previa is more common in multiple pregnancies due to number and size of placentas present. The majority of women pregnant with multiples eventually develop iron-deficiency anemia. Mothers of multiples develop gestational diabetes two or three times more often than those with single pregnancies. Preeclampsia occurs in about ten percent of single pregnancies, while it occurs in nearly one third of multiple pregnancies. Pre term labor occurs in approximately 50% of twins, and 90% of triplets.
Hidden Costs of Multiple Pregnancies
When evaluating whether to transfer a single embryo or multiple embryos a couple can easily determine their upfront costs. If they have insurance that covers IVF they probably research what their out-of-pocket costs will be. Most couples have no such coverage, so they may know these upfront costs very well. And the biggest determining factor in the cost of getting pregnant via IVF is the number of cycles required. Multiple transfers may lower the need for multiple cycles and lower upfront costs.
But what about the costs associated with multiple pregnancies? Many of these costs are hidden. Unfortunately couples must find out the hard way, only after depleting savings or taking on debt to get pregnant in the first place.
Some hidden costs might include mom's lost income if she experiences one of the more common pregnancy complications associated with a multiple pregnancy. A normal pregnancy last for nine months. What if complications arise in the first month and your doctor orders immediate bed rest?
Pre term labor is very common with multiples as described above. Pre term babies are often confined to a Neonatal Intensive Care Unit (NICU). Many insurance plans contain a hospital deductible or co-pay that may be then applied to each child confined. Premature infants are at a higher risk of hearing loss, vision problems, and developmental delays. Many diagnostic tests are not covered by insurance, and an extremely sick infant may require one or both parents to take an extended unpaid family medical leave.
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