Figure 1. Different factors that influence the higher cost of multiple pregnancies compared to singletons. PIH=pregnancy induced hypertension. HELLP=hemolysis,

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Figure 1. Different factors that influence the higher cost of multiple pregnancies compared to singletons. PIH=pregnancy induced hypertension. HELLP=hemolysis, elevated liver enzymes, low platelets. From: Multiple gestation and infertility treatment: registration, reflection and reaction—the Belgian project Hum Reprod Update. 2005;11(1):3-14. doi:10.1093/humupd/dmh048 Hum Reprod Update | Human Reproduction Update vol. 11 no. 1 © European Society of Human Reproduction and Embryology 2004; all rights reserved

Figure 2. (a) Belgian register for assisted procreation (BELRAP) 1990–2002: number of embryos transferred. (b) BELRAP 1990–2000: number of babies delivered From: Multiple gestation and infertility treatment: registration, reflection and reaction—the Belgian project Hum Reprod Update. 2005;11(1):3-14. doi:10.1093/humupd/dmh048 Hum Reprod Update | Human Reproduction Update vol. 11 no. 1 © European Society of Human Reproduction and Embryology 2004; all rights reserved

Figure 3. Reducing the multiple pregnancy rate in IVF-related procedures using fresh embryos: the Belgian strategy. From: Multiple gestation and infertility treatment: registration, reflection and reaction—the Belgian project Hum Reprod Update. 2005;11(1):3-14. doi:10.1093/humupd/dmh048 Hum Reprod Update | Human Reproduction Update vol. 11 no. 1 © European Society of Human Reproduction and Embryology 2004; all rights reserved

Figure 4. (a) Belgian project of assisted reproduction reimbursement: short-term benefit considering that 70% of twins and 100% of triplets are admitted to the neonatal intensive care with a mean estimated cost of €12 500 per baby. OPR = ongoing pregnancy rate. (b) Belgian project of assisted reproduction reimbursement: long-term benefit considering that 3.7% of twins and 7.2% of triplets are severely handicapped with major neurological or developmental disability. (Yokoyama et al., 1995) with a mean lifetime cost of €1.5–2.0 million per baby (Nishida, 1993). From: Multiple gestation and infertility treatment: registration, reflection and reaction—the Belgian project Hum Reprod Update. 2005;11(1):3-14. doi:10.1093/humupd/dmh048 Hum Reprod Update | Human Reproduction Update vol. 11 no. 1 © European Society of Human Reproduction and Embryology 2004; all rights reserved