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Jeff Brody
Litigators Inc.
In-vitro fertilization has increased rapidly in the last 25 years significantly improving a woman's chances of giving birth. Of the 48,000 children born in the United States through IVF and similar technologies, 34 percent result in multiple births. However, these tiny miracles come with some sobering consequences.
Multiple Births: Risk Factor for Cerebral Palsy
According to the health experts and advocacy groups such as the March of Dimes, multiple births pose a heightened risk of disabilities and birth defects such as cerebral palsy in newborns. Since 1980, the rate of twin births has soared almost 90 percent in the U.S. and the number of triplets has risen more than five times.
The increased risk of defects in multiple births is partly due to the fact that over 60 percent of all multiple births are delivered prematurely. A study conducted by the California Birth Defects Monitoring Program found that children born of twin sets were seven times more likely to have cerebral palsy than those in the general birth population.
Efforts to Lower Multiple Births
There have been several attempts made by different agencies and organizations to stem the incidence of multiple births. In 1999, the American Society for Reproductive Medicine, a group of reproductive experts recommended specific guidelines that would limit the number of embryos used in IVF.
They suggested no more than two embryos in women under 35 who produce healthy eggs. Women older than 35 whose pregnancy success rate is generally lower and women with poor-quality embryos may receive more. In 2004, these voluntary guidelines were made stricter.
However, a recent analysis of the Center for Disease Control statistics indicates that many doctors are working outside the industry's suggested practices. In 2003, 113 out of 395 IVF clinics were using at least three embryos in woman under 35. Thirteen clinics transferred four or more eggs and the number increased in women over 35.
Joseph Isaacs, president of Resolve, an infertility advocacy group, blames the lack of insurance coverage for the high number of embryos being transferred in women. He claims that if more insurance policies covered infertility treatments in the U.S., then parents wouldn't feel pressured to transfer many embryos at one time.
Ethicist Jonathan Moreno of the University of Virginia doesn't believe lack of insurance makes it okay for parents to take measures that could heighten the risk of birth defects. “We do not have endless resources, and decision have to be made about what is more critical and less critical to the community,” Moreno said.