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Fertility doctors aim to lower rate of multiple births

| Monday, Dec. 2, 2013, 8:03 p.m.

BOSTON — In the five years since the “Octomom” case, big multiple births have gone way down, but the twin rate has barely budged. Fertility experts are pushing a new goal: one.

A growing number of couples are attempting pregnancy with a single embryo, helped by new ways to pick the ones most likely to succeed. Guidelines urge doctors to stress this approach.

Twins aren't always twice as nice; they have much higher risks of prematurity and serious health problems.

Abigail and Ken Ernst of Oldwick, N.J., used the one-embryo approach to conceive Lucy, a daughter born in September. It “just seemed the most normal, the most natural way” to conceive and avoid a high-risk twin pregnancy, the new mom said.

Not all couples feel that way, though. Some can only afford one try with in vitro fertilization, so they insist that at least two embryos be used to boost their odds and view twins as two for the price of one.

The 2009 case of a California woman who had octuplets using IVF focused attention on the issue of big multiple births, and the numbers have dropped, except for twins.

The Centers for Disease Control and Prevention's most recent numbers show that 46 percent of IVF babies are multiples— mostly twins —and 37 percent are born premature. By comparison, only 3 percent of babies born without fertility help are twins, and about 12 percent are preterm.

It's mostly an American problem. Some European countries that pay for fertility treatments require using one embryo at a time.

The American Society for Reproductive Medicine is trying to make it the norm in the United States, too. Its guidelines, updated this year, say that for women with reasonable medical odds of success, those younger than 35 should be offered single embryo transfer and no more than two at a time.

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