The Cost of Twins

Sunday October 11, 2009

There's an interesting article at the New York Times online titled "The Gift of Life, and Its Price." The article talks about IVF treatment and the rate at which twin pregnancies result. It goes on to explain that while many people think of twins as not a "big deal" risk wise, the fact of the matter is that twins are riskier than a singleton pregnancy.

Twins are conceived from IVF treatment often because couples choose to have two or more embryos transferred, rather than one, to increase the odds of success. The hope is that at least one baby will "stick", but often, both babies stick, leading to twins.

The article also talks about how much more expensive twins are, in terms of medical costs, and that this is one of many reasons single-embryo transfer should be used for IVF treatment, in women with a high chance of success.

In my opinion, the article spends very little wordage on one of the biggest barriers to single-embryo transfer - and that's the cost to a couple who is going through fertility treatment.

Yes, it's true -- the overall medical costs for twins can be much, much higher. But couples rarely see that expense. Health insurance usually covers the bill. On the other hand, the cost of IVF treatment is often solely paid for by the couple. When looking at their budget, opting for two embryos instead of one embryo looks like the best choice (especially when the risks of twin pregnancies aren't understood, or when they can only afford one treatment cycle).

I know that at least a few fertility clinics have started offering incentives to those opting for a single embryo transfer. The deal is that you pay for the first treatment cycle, and they will freeze any extra embryos and transfer them at a later cycle if the first treatment cycle fails, without added cost. This is an excellent idea.

The question is, how popular will it become? I'd like to see it become standard protocol, and I suspect that would be more likely if insurance companies were paying for treatments. (They seem to have a way of reducing costs when they want to.)

I have a feeling if health insurance had to cover fertility treatment, it'd be good for everyone - even those insurance companies who are now refusing to cover IVF.

It'd be better for the doctors, as they would get more business (from those who could not otherwise afford treatment).

It'd be better for the couples, who wouldn't feel as pressured to transfer more than one embryo at a time.

It'd be better for the insurance companies, who could spend a little now to increase a couple's odd at having one baby, instead of paying high costs when multiples result instead.

And it'd be better for the babies, who might have a better chance at being born at the right time.

What are your thoughts? Please share in the comments below, I want to hear from you!

More about twins and fertility treatment risks: