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Having twins is cheaper?

A US researcher's argument that twins should be the goal of in vitro fertilisation drew opposition from many researchers on Monday who warned of the risks of multiple pregnancies.

Presenting a study at the annual meeting of the European Society of Human Reproduction and Embryology, Norbert Gleicher said twins are a solution for infertile couples who want more than one child.

His review of previous studies found that it is cheaper for couples to have twins because it can cut the number of treatments, and the risk is not significantly greater for mother and child.

"For infertile patients, desirous of more than one child, twin deliveries represent a favorable, cost effective and ethical treatment outcome, which in contrast to current medical consensus, should be encouraged," Norbet, of the Center for Human Reproduction, in New York said.

Experts at odds with findings
Many experts disagreed. A statement issued by committee members at the European Society of Human Reproduction and Embryology said Geichler's study does not deal with, among other issues, increased late losses with multiple pregnancies.

The group also criticized what it called a failure to mention financial costs to the parents of twins and to healthcare systems involved in caring for a mother and her children.

"It does not deal at all with increased late losses of multiple pregnancy," said the statement signed by Francoise Shenfield of University College, London and Peter Braude of Guy's Hospital in London.

"It is not reasonable to equate two single-spaced pregnancies with twins; being up all night with newly born twins, the doubling of the initial outlay costs, and the significant stresses of bringing up two toddlers are all material."

Faster science grows, more ethical questions arise
Shenfield added that these kinds of issues highlight the growing ethical problems fertility experts face as the rapid pace of scientific advancement makes so much more possible.

And with an estimated one in six couples worldwide experiencing some form of infertility problem at least once, demand for treatment is rising.

"There is something very particular about ethics in this field because you have to think about the interests of the man and the woman, and any future child," Shenfield said. "The scientific advances we have seen have made that more acute."

British researcher Vasanti Jadva of Cambridge University presented a different kind of dilemma in her study showing children born after donor insemination should be told at an early age about it because those told later are more likely to feel shock or anger.

And ethicist Wybo Dondorp, a researcher at Maastricht University in the Netherlands told fellow researchers that doctors should listen to parents who ask to use embryos that could result in a child with a developmental problem if they do not have a healthy embryo to choose.

"As the couple's primary wish may be for a child, they may reason that if a non-affected, healthy child is not what they can get, they will also be happy with, and good parents for, a child with a condition they at first intended to avoid." – (Reuters Health)

July 2008

Read more:
New hope for fertility
IVF success may be predicted

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