Prevention of multiple pregnancies; the Belgian project

Due to the epidemic of iatrogenic multiple births as a result of infertility treatment, the incidence of maternal, perinatal and childhood morbidity and mortality has increased. This results in a much higher healthcare cost of infertility therapy which may lead to social and political concern. Reducing the number of embryos transferred and/or the use of natural cycle IVF will surely decrease the number of multiple gestations after assisted reproductive technologies. Single embryo transfer in selected cases seems to be the best option in reducing the number of multiples after IVF/ICSI. Consequently, optimised cryopreservation programmes will be essential. Excellent data collection of all infertility treatments is needed in our discussion with policymakers. The Belgian project in which reimbursement of ART-related laboratory activities is linked to a transfer policy aiming at substantial multiple pregnancy reduction and, taking into account the age and cycle number of the patient, is a nice example of forward-looking health economics. (C) 2004 Elsevier B.V. All rights reserved.