We often hear people say with admiration, “Twins are so cute!” However, from an obstetrician’s perspective, multiple pregnancy is considered a “high-risk pregnancy.”
For the mother: The risks of gestational hypertension, gestational diabetes, cesarean delivery, and significant blood loss are increased.
For the fetus: There is a risk of pregnancy loss, and the most common complication is still premature birth. Premature infants often have low birth weight and immature lungs, and they may require respiratory support or admission to an intensive care unit. They generally cannot be discharged until they can breathe independently, take nutrition orally, maintain a normal body temperature, and gain weight steadily. In the long term, premature birth may also affect a child’s growth, hearing, vision, and even learning ability.
If a baby is born prematurely, the effects of prematurity may continue throughout life. Caring for a premature infant can therefore place a substantial emotional and financial burden on the family.
The most important goal of pregnancy is to give birth to and raise a healthy child. In the past, embryo culture techniques, equipment, culture media, and cryopreservation methods were not as advanced as they are today. To increase pregnancy rates, multiple embryos were often transferred during a single procedure. This resulted in a higher rate of multiple pregnancies, creating stress for families and increasing pregnancy-related risks for both mothers and babies.
Today, reproductive medicine continues to advance. Over the past decade, reproductive medicine specialists both in Taiwan and internationally have increasingly focused on achieving the birth of a healthy, full-term singleton while avoiding multiple pregnancies. For this reason, “Single Embryo Transfer (SET)” is strongly recommended. Our center fully supports this concept.
In recent years, the rate of “Single Embryo Transfer (SET)” in Taiwan was 24.9% in 2019, compared with 82.1% in Japan in 2016. Only about 3% of IVF births in Japan resulted in twins, compared with 24.1% in Taiwan, showing a substantial difference between the two countries.
According to statistics from Taiwan’s Health Promotion Administration, the annual medical costs associated with premature infants account for a significant portion of high-cost neonatal health insurance expenditures. To reduce multiple pregnancies, the IVF subsidy program introduced on July 1, 2021 also limits the number of embryos transferred per procedure: women aged 35 or younger may receive one embryo per transfer, while women aged 36 or older may receive a maximum of two embryos. This approach can create benefits for the public, the medical community, and the government.
For the public: Reduce the rates of multiple pregnancy and high-risk pregnancy, increasing the likelihood of safely delivering a healthy, full-term baby.
For the medical community: Improve treatment and care at reproductive medicine centers while reducing the burden placed on obstetric and pediatric services by multiple births and premature infants.
For the government: Reducing high-risk pregnancies and premature births can help decrease intensive medical care costs and may also contribute to addressing the declining birth rate.
During the early implementation of the IVF subsidy program, many physicians and patients may have worried that limiting the transfer of multiple embryos would reduce pregnancy rates. However, at our center, 67% of embryo transfers are “Single Embryo Transfers,” far above Taiwan’s national average of 24.9%, while the pregnancy rate remains as high as 60%! This demonstrates that “Single Embryo Transfer” in IVF treatment is both highly safe and feasible.