New Belgian embryo transfer policy leads to sharp decrease in multiple pregnancy rate

Area of Science:

• Reproductive Medicine
• Public Health Policy
• In Vitro Fertilization (IVF)

Background:

• Belgium implemented a new fertility policy on July 1, 2003, to decrease multiple pregnancies.
• The policy regulates the number of embryos transferred based on patient age and treatment cycle.

Purpose of the Study:

• To evaluate the impact of Belgium's national embryo transfer policy on pregnancy outcomes.
• To assess changes in human chorionic gonadotrophin (HCG) rates, clinical pregnancy rates, and multiple pregnancy rates.

Main Methods:

• A comparative study analyzing two 15-month periods before and after the policy implementation.
• Data stratified by patient age categories: <36, 36-39, and 40-42 years.
• Key outcome measures included positive HCG, clinical pregnancy, and multiple pregnancy rates.

Main Results:

• Clinical pregnancy and HCG rates remained consistent post-policy (26.2% vs. 24.0% and 34.2% vs. 32.8%, respectively).
• Overall multiple pregnancy rates decreased significantly from 29.1% to 9.5%.
• A marked reduction in multiple pregnancies was observed in women under 36 (28.9% to 6.2%).

Conclusions:

• The Belgian embryo transfer policy effectively reduced multiple pregnancies without negatively impacting clinical pregnancy rates.
• Further consideration of elective single embryo transfer is recommended for women aged 36-39.
• The policy demonstrated a significant (P < 0.001) decline in multiple births, primarily in younger age groups.