The decline in triplet and higher-order births over the last 25 years has been associated with changes to guidance related to the number of embryos transferred during assisted reproductive technology use.
Implanting more than one embryo created through in vitro fertilization increases the chance of pregnancy - and is cheaper than going through several cycles.
As multiple births became more common, the American Society for Reproductive Medicine and the Society for Assisted Reproductive Technology issued guidelines in the late 1990s recommending the maximum number of embryos for transfer.
Now, ASRM recommends transferring just one embryo in most cases. For women older than 40, no more than four untested early-stage embryos should be implanted at once.
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