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Funding and public reporting strategies for reducing multiple pregnancy from fertility treatments

Research output: Contribution to journalReview articlepeer-review

Georgina M. Chambers, Elena Keller, Stephanie Choi, Yakoub Khalaf, Sara Crawford, Willings Botha, William Ledger

Original languageEnglish
Pages (from-to)715-721
Number of pages7
JournalFertility and Sterility
Issue number4
PublishedOct 2020

Bibliographical note

Publisher Copyright: © 2020 American Society for Reproductive Medicine Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

King's Authors


The health of children born through assisted reproductive technologies (ART) is particularly vulnerable to policy decisions and market forces that play out before they are even conceived. ART treatment is costly, and public and third-party funding varies significantly between and within countries, leading to considerable variation in consumer affordability globally. These relative cost differences affect not only who can afford to access ART treatment, but also how ART is practiced in terms of embryo transfer practices, with less affordable treatment creating a financial incentive to transfer more than one embryo to maximize the pregnancy rates in fewer cycles. One mechanism for reducing the burden of excessive multiple pregnancies is to link insurance coverage to the number of embryos that can be transferred; another is to combine supportive funding with patient and clinician education and public reporting that emphasizes a “complete” ART cycle (all embryo transfers associated with an egg retrieval) and penalizes multiple embryo transfers. Improving funding for fertility services in a way that respects clinician and patient autonomy and allows patients to undertake a sufficient number of cycles to minimize moral hazard improves outcomes for mothers and babies while reducing the long-term economic burden associated with fertility treatments.

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