Avoiding multiple pregnancies in ART: Replace as many embryos as you like--one at a time

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Abstract
There has been much concern over the years about the health of children born following assisted reproduction and whether they are at increased risk of abnormality. Most recently this concern has focused around children born to infertile fathers following intracytoplasmic sperm injection (ICSI) and a number of important follow-up studies are underway. However any putative risks in this respect pale into insignificance when compared with the morbidity in children born of high order multiple pregnancy. Even twins, generally regarded as a happy outcome of IVF, run increased risks of dying or ending up with handicap, compared with singleton pregnancies (Bergh et al., 1999). How can doctors, rightly concerned with the welfare of their patients and their offspring, have allowed this? It is disappointing that in the UK, with so much discussion and debate about the welfare of the child, the greatest risk to the health of the child, namely the risk of being born premature, continues to be regarded in many quarters as something of a side issue.

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