The health of children born through assisted reproductive technologies (ART) is particularly vulnerable to policy decisions and market forces that play out before they are even conceived. ART treatment is costly, and public and third-party funding varies significantly between and within countries, leading to considerable variation in consumer affordability globally. These relative cost differences affect not only who can afford to access ART treatment, but also how ART is practiced in terms of embryo transfer practices, with less affordable treatment creating a financial incentive to transfer more than one embryo to maximize the pregnancy rates in fewer cycles. One mechanism for reducing the burden of excessive multiple pregnancies is to link insurance coverage to the number of embryos that can be transferred; another is to combine supportive funding with patient and clinician education and public reporting that emphasizes a "complete" ART cycle (all embryo transfers associated with an egg retrieval) and penalizes multiple embryo transfers. Improving funding for fertility services in a way that respects clinician and patient autonomy and allows patients to undertake a sufficient number of cycles to minimize moral hazard improves outcomes for mothers and babies while reducing the long-term economic burden associated with fertility treatments.

中文翻译：

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减少生育治疗导致多胎妊娠的资金和公共报告策略

通过辅助生殖技术 (ART) 出生的儿童的健康特别容易受到政策决定和市场力量的影响，这些政策甚至在他们怀孕之前就发挥了作用。ART 治疗费用高昂，而且国家之间和国家内部的公共和第三方资助差异很大，导致全球消费者的负担能力存在很大差异。这些相对成本差异不仅影响谁有能力接受 ART 治疗，还影响在胚胎移植实践方面如何实施 ART，负担得起的治疗产生经济激励，以转移一个以上的胚胎，以在更少的周期内最大限度地提高怀孕率. 减少过度多胎妊娠负担的一种机制是将保险范围与可移植的胚胎数量联系起来；另一种方法是将支持性资金与强调“完整”ART 周期（与取卵相关的所有胚胎移植）并惩罚多次胚胎移植的患者和临床医生教育和公开报告相结合。以尊重临床医生和患者自主权的方式增加对生育服务的资助，并允许患者进行足够数量的周期以最大程度地减少道德风险，从而改善母亲和婴儿的结果，同时减少与生育治疗相关的长期经济负担。