(Press-News.org) While fertility treatments have helped many people become parents, they commonly result in multiple births, increasing the risk of prematurity, and leading to lifelong complications. But this doesn't have to be the case, according to Yale School of Medicine researchers and their colleagues, who recommend sweeping changes to policy and clinical practice in a study published in the April issue of Fertility & Sterility.
Pasquale Patrizio, M.D., professor in the Department of Obstetrics, Gynecology & Reproductive Sciences at Yale School of Medicine, and his colleagues at the Hastings Center identified several changes in policy and practice that can reduce the odds of multiple births and prematurity, expand insurance coverage for in vitro fertilization (IVF), and improve doctor-patient communications about the risks associated with twins.
IVF can cost upwards of $10,000 for a full cycle. Because few Americans have sufficient insurance coverage for fertility treatments, some patients feel financially compelled to maximize their pregnancy chances by implanting multiple embryos, despite the health risks and long-term costs associated with multiple gestations and births.
"Failure to cover these services causes harm to patients in addition to leading to multiple births," said Patrizio. "When patients are better informed of the risks of multiples, and relieved of the financial pressures, research shows that they are more likely to choose to transfer one embryo at a time."
Patrizio and his colleagues developed their recommendations through a research project that for the first time brought together fertility experts, representatives from the insurance industry and professional associations, and bioethicists. At a workshop, the group examined the causes and consequences of multiple births after fertility treatments.
Patrizio said the most promising changes should include: expanding insurance coverage to reduce the financial pressure on patients to prioritize pregnancy chances over safety; altering the definition of an IVF cycle so that two consecutive single embryo transfers is equivalent to one double embryo transfer for the purposes of calculating success rates and insurance benefits; investing in research to improve treatment efficacy and safety; fully informing patients of the likelihood of, and risks associated with, multiples; and altering clinic, insurer, and state policies to better enable patients to choose low-risk protocols.
"These policies have already been instituted in some European countries, and have resulted in a dramatic reduction in the rates of multiple births after IVF, while maintaining good live-birth rates," said Patrizio.
Other authors on the study include Josephine Johnston, a research scholar and director of research at The Hastings Center and Michael K. Gusmano, a Hastings Center research Scholar.
The study was funded by the March of Dimes.
Citation: Fertility & Sterility doi:10.1016/j.fertnstert.2014.03.019
Multiple births don't have to be an inevitable result of fertility treatments
ELSE PRESS RELEASES FROM THIS DATE:
Ant colonies help evacuees in disaster zones
An escape route mapping system based on the behavior of ant colonies could give evacuees a better chance of reaching safe harbor after a natural disaster or terrorist attack by building a map of showing the shortest routes to shelters and providing regular updates of current situations such as fires, blocked roads or other damage via the smart phones of emergency workers and those caught up in the disaster. Koichi Asakura of Daido University in Nagoya and Toyohide Watanabe of the Nagoya Industrial Science Research Institute in Japan have carried out successful simulations ...
New Geosphere series: The St. Elias Erosion/Tectonics Project in Southern Alaska
Boulder, Colo., USA – GEOSPHERE has added a new themed issue to its roster: "Neogene tectonics and climate-tectonic interactions in the southern Alaskan orogeny." Interest in Alaskan tectonics has varied over time, propelled mostly by geologic hazards. In 1964, the great Alaskan earthquake focused attention on Alaska and was a major factor in the establishment of the concept of subduction in the early days of plate tectonics. In the 1980s, the northern Cordillera, including Alaska, was the subject of extensive study using the terrane analysis approach, which spawned ...
Diverse gene pool critical for tigers' survival, say Stanford scholars
New research by Stanford scholars shows that increasing genetic diversity among the 3,000 or so tigers left on the planet is the key to their survival as a species. Iconic symbols of power and beauty, wild tigers may roam only in stories someday soon. Their historical range has been reduced by more than 90 percent. But conservation plans that focus only on increasing numbers and preserving distinct subspecies ignore genetic diversity, according to the study. In fact, under that approach, the tiger could vanish entirely. "Numbers don't tell the entire story," said study ...
UT Arlington physicist creates new nanoparticle for cancer therapy
A University of Texas at Arlington physicist working to create a luminescent nanoparticle to use in security-related radiation detection may have instead happened upon an advance in photodynamic cancer therapy. Wei Chen, professor of physics and co-director of UT Arlington's Center for Security Advances Via Applied Nanotechnology, was testing a copper-cysteamine complex created in his lab when he discovered unexplained decreases in its luminescence, or light emitting power, over a time-lapse exposure to X-rays. Looking further, he found that the nanoparticles, called ...
Using video surveillance to measure peoples' hand washing habits
One of the best defenses against infectious disease is one of the most simple – hand washing. Still, despite years of global public awareness campaigns, hand washing rates remain low. Caregivers of young children in low-income, developing world settings are found to wash their hands only 17 percent of the time after using the toilet. A new study finds that video surveillance can provide insights into hand washing behavior. When another person is present, for example, hand washing rates increase 23 percent. These findings could, in turn, inform the design, monitoring ...
Irrigated agriculture -- precious habitat for the long-billed curlew
Petaluma, CA – Despite the recent rainfall, California is still in a drought, so not only are water supplies limited, but demand for water is increasing from a variety of uses. In a recent study published by Point Blue Conservation Science (Point Blue) and Audubon California in the journal Western Birds, scientists document the importance of irrigated agricultural crops in California's Central Valley to a conspicuous shorebird. Crops like alfalfa provide critical habitat for the Long-billed Curlew, the largest shorebird in North America and a species of continental conservation ...
Body Mass Index associated with breast cancer, regardless of body shape
ATLANTA – April 16, 2014— A study of predominantly white women finds a larger waist circumference is associated with higher risk of postmenopausal breast cancer, but not beyond its contribution to BMI. The study, by American Cancer Society researchers, fails to confirm previous findings that body shape itself is an independent risk factor for breast cancer. The current study appears in the April 2014 issue of Cancer Causes, and Control. A significant body of research has linked abdominal obesity to a number of conditions, including heart disease, type II diabetes, and ...
A study in scarlet
This area of the southern sky, in the constellation of Centaurus (The Centaur), is home to many bright nebulae, each associated with hot newborn stars that formed out of the clouds of hydrogen gas. The intense radiation from the stellar newborns excites the remaining hydrogen around them, making the gas glow in the distinctive shade of red typical of star-forming regions. Another famous example of this phenomenon is the Lagoon Nebula (eso0936 - http://www.eso.org/public/news/eso0936/), a vast cloud that glows in similar bright shades of scarlet. The nebula in this picture ...
Warm US West, cold East: A 4,000-year pattern
SALT LAKE CITY, April 16, 2014 – Last winter's curvy jet stream pattern brought mild temperatures to western North America and harsh cold to the East. A University of Utah-led study shows that pattern became more pronounced 4,000 years ago, and suggests it may worsen as Earth's climate warms. "If this trend continues, it could contribute to more extreme winter weather events in North America, as experienced this year with warm conditions in California and Alaska and intrusion of cold Arctic air across the eastern USA," says geochemist Gabe Bowen, senior author of the ...
Scientists achieve first direct observations of excitons in motion
A quasiparticle called an exciton — responsible for the transfer of energy within devices such as solar cells, LEDs, and semiconductor circuits — has been understood theoretically for decades. But exciton movement within materials has never been directly observed. Now scientists at MIT and the City College of New York have achieved that feat, imaging excitons' motions directly. This could enable research leading to significant advances in electronics, they say, as well as a better understanding of natural energy-transfer processes, such as photosynthesis. The research ...