The Costs of Multiple Gestation Pregnancies in Assisted Reproduction

Harvard Journal of Law and Gender, Vol. 32, 2009

42 Pages Posted: 6 May 2009

See all articles by Urska Velikonja

Urska Velikonja

Georgetown University Law Center

Date Written: May 6, 2009


The United States, unlike most developed countries, does not regulate its fertility industry. Rather, it vests control over the industry to professional organizations and to market forces. While lack of regulation has produced a vibrant market for fertility services, it has also produced an undesirable consequence: a high rate of multiple gestation pregnancies, including twin pregnancies. This Article summarizes the data on the medical, psychological, and financial costs associated with multiple pregnancies to the parents, the children, and American society. It suggests that the current U.S. regulatory regime has not only failed to address these costs as they surfaced but may also have aggravated the problem. It compares the U.S. regime to approaches taken in Europe to reduce the rate of multiple gestation pregnancies and suggests that governmental intervention may be necessary. Finally, the Article proposes that regulation to improve reporting, disclosure, and clinic supervision, combined with more strictly enforced embryo transfer practices would reduce the costs of multiple births without impermissibly burdening the freedom to procreate. This proposed regulation is not only desirable, but it would also likely pass constitutional muster.

Keywords: ART, assisted reproductive technolgy, infertility, multiple gestation, pregnancy, costs

JEL Classification: H51, I11, J13

Suggested Citation

Velikonja, Urska, The Costs of Multiple Gestation Pregnancies in Assisted Reproduction (May 6, 2009). Harvard Journal of Law and Gender, Vol. 32, 2009, Available at SSRN:

Urska Velikonja (Contact Author)

Georgetown University Law Center ( email )

600 New Jersey Avenue, NW
Washington, DC 20001
United States

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