The impact of the new Turkish regulation, imposing single embryo transfer after assisted reproduction technology, on neonatal intensive care unit utilization: a single center experience

Abstract

IVF has become an efficient and widely used treatment for infertile couples, however, it is responsible for an increasing number of multifetal pregnancies and adverse neonatal outcomes. This study aimed to assess a health service utilization in one neonatal intensive care unit (NICU), as a response to the 2010 Turkish reproductive regulation requiring single embryo transfer (SET). All assisted reproductive technology (ART) pregnancies delivered at Zekai Tahir Burak Maternity Teaching Hospital between February 2010 and October 2011 were included in this study. Subjects were divided into two groups: Group 1 consisted of infants conceived before the ART regulation, and born between February 2010 and October 2010, and Group 2 consisted of infants conceived after the ART regulation, and born between November 2010 and October 2011. Upon comparing the study groups, we observed a significant decrease in the incidence of multiple births in Group 2. The mean gestational age and mean birthweight were significantly higher in Group 2. The rates of prematurity and low birthweight, very low birthweight and extremely low birthweight infants were significantly lower in Group 2. Similarly, the rates of NICU admission, respiratory distress syndrome, necrotizing enterocolitis anemia and pneumonia/sepsis, and the need for respiratory support (mechanical ventilation and nasal continuous positive airway pressure) were significantly lower in Group 2. According to our data, NICU utilization was reduced and the early post-natal outcomes of the babies were improved after the new Turkish regulation on ART imposing SET. However, multicenter studies are needed to generalize our results to the whole country.