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From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.

The birthrate for twins and triplets in the U.S. has soared by 70 percent in recent decades, thanks in large part to new technologies to overcome infertility. But the rise in multiple births means more premature babies and health complications.

NPR's Jennifer Ludden reports on�a new study that�finds providing insurance coverage for fertility treatments means fewer multiple births.

JENNIFER LUDDEN: Specifically, the study looks at in vitro fertilization, or IVF. That's where sperm and egg are mixed in a laboratory, then one or more embryos are put into a woman's uterus. More means a greater likelihood of getting pregnant but also a greater risk of twins or triplets.

Dr. Pasquale Patrizio of Yale Fertility Center says patients are more likely to take that risk when they're the ones who pay.

Dr. PASQUALE PATRIZIO (Director, Yale Fertility Center): The average number of embryos that were transferred in the states where patients have to pay is 2.6. While in states where the insurance covers, it's 2.2.

LUDDEN: His study in the current issue of Fertility and Sterility, finds this translates into two percent fewer multiple births in states that require IVF coverage. It may not sound like much, but Patrizio says given the severe medical complications many such infants can face, it is highly significant.

Dr. PATRIZIO: When you do the calculation in terms of cost, it is much more economical to provide the service up front and not to end up with twins and triplets.

LUDDEN: J.P. Wieske isn't so sure. He's with the Council for Affordable Health Insurance, which opposes mandates in general.

Mr. J.P. WIESKE (Executive Director, Council for Affordable Health Insurance): You're looking at doing those procedures again and again until you reach your success rate. You may not find that there is any savings at all when you actually add up the numbers.

LUDDEN: In any case, only eight states currently require insurers to cover IVF.

In�another study this week, Keith Barrington of Sainte-Justine University Hospital in Montreal, suggests the greatest savings happen when only one embryo is used in IVF. Several European countries with national health care mandate this. Barrington says Quebec began doing so last year.

Dr. KEITH BARRINGTON (Neonatology, Sainte-Justine University Hospital): The number of twin pregnancies has gone from 30 percent to under four percent. And there's no triplets.

LUDDEN: Barrington says such a requirement in the U.S. could prevent the deaths of 700 premature twins and triplets a year. There is no talk of such a policy here, though one insurance company, Aetna, has started encouraging single embryo transfer by offering patients two IVFs for the price of one.

Jennifer Ludden, NPR News.

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