Research in France has revealed that triplet pregnancies cost more than eight times as much as singleton pregnancies, and twin pregnancies cost more than three times as much, the 21st annual conference of the European Society of Human Reproduction and Embryology heard.
Lead author, Dr Jacques de Mouzon, said that, together with the known medical risks for both mothers and babies of multiple pregnancies, the economic costs underlined the necessity of preventing multiple pregnancies during assisted reproduction technology (ART).
He said: "Normally, the cost calculations of assisted reproduction are limited to the cost of the treatment cycle alone. However, it seems clear to me that it is equally important to count the costs of hospitalisation, delivery according to the method of delivery, and neonatal care. This gives a much better view of the reality.
"The resulting figures show that multiple pregnancies have a very important economic impact, which should be considered together with the medical risks. Moreover, this study did not analyse the long-term costs, relating to cerebral palsy and handicaps that are much more frequent in multiple birth babies than in singletons. These figures reinforce the necessity of preventing their occurrence with an adapted policy on ART and stimulation regimen in other fertility treatments.
"Research shows that for healthy women, under the age of 40, who are ovulating normally, single embryo transfer, maybe over more than one cycle, achieves a similar pregnancy rate as transferring two or more embryos in one cycle – and with far fewer risks to the mothers and babies. With older women, or those with more problems, this is not necessarily the case. However, the money that is saved by avoiding the higher costs of multiple pregnancies in these younger women could be used instead to increase the numbers of cycles offered to women and enable more ART children to be born."
Dr de Mouzon, a specialist in public health and epidemiology and head of the human reproduction epidemiology team at the INSERM Unit U569, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France, said that in his country twin pregnancies had increased by 40% and triplet pregnancies by 300%. "Infertility treatments are the cause of 30% of all twins and 60% of all triplets born in France."
Using information from a number of sources including the French register on IVF, Fivnat, Dr de Mouzon calculated the cost in Euros of hospitalisation, delivery according to mode of delivery (e.g. non-interventional, delivery with the aid of instruments, and Caesarean sections), and neonatal care of ART babies born in the year 2000.
He found that the total cost per pregnancy was Euro4,614 for singletons, Euro12,730 for twins and Euro39,320 for triplets. These figures broken down showed that the cost of the pregnancy was Euro3,016 for singletons, Euro4,970 for twins and Euro9,104 for triplets, while the neonatal cost per baby was Euro1,598, Euro3,080 and Euro10,072 respectively.
When Dr de Mouzon applied these figures to the French IVF results of 2000 he found that the national costs of 6,246 ART singleton pregnancies was Euro26.8m, 2,099 twin pregnancies cost Euro26.6m, and 118 triplet pregnancies cost Euro4.6m.