The Costs of Multiple Gestation Pregnancies in Assisted Reproduction
Abstract
The United States, unlike most developed countries, does not regulate its fertility industry. Rather, it has vested control over the industry to professional organizations and to market forces. While lack of regulation has produced a vibrant market for ART services, it has also produced an undesirable consequence: a high rate of multiple gestation pregnancies. In this article I summarize the data on the medical, psychological, and financial costs associated with multiple pregnancies to the parents, the children, and the American society. I suggest that the current U.S. regulatory regime has not only failed to address these costs as they surfaced, but may have aggravated the problem. I compare the U.S. regime to approaches taken in Europe to reduce the rate of multiple gestation pregnancies, and suggest that governmental intervention may be necessary. Finally, I propose that that regulation to improve reporting, disclosure, and clinic supervision, combined with more strictly enforced embryo transfer practices would reduce the costs of multiple births without severely limiting the freedom to procreate.