Many couples are telling their physicians that they want twins because they view twins as two for the price of one. Doctors are concerned about an “epidemic of twins “since nearly half of all babies born with advanced fertility help are multiple births. In the past five years, the twin rate has barely moved. Therefore, doctors are trying to make patients aware that twins aren’t always twice as nice. Serious health problems and risks of prematurity are of higher rates in twins. Fertility experts want couples to attempt pregnancy with just a single embryo. A couple, Abigail and Ken Ernst, followed this approach of using one embryo at a time. They say it seemed like the most natural way to conceive and avoid high-risk twin pregnancy. Others may not be able to afford multiple tries with in vitro fertilization. So they insist on using two embryos to boost their chances and possibly get two children for the price of one. Barbara Collura, president of Resolve a support and advocacy group comments, “We as a society, think twins are healthy and always come out great. There’s very little reality about the increased medical risks for babies and moms.” Unfortunately, the statistics from The Centers for Disease Control and Prevention’s most recent numbers show that 46 percent of IVF babies are multiples (mostly twins). Of these 37 percent are born premature. The problem of using two embryos at a time instead of one is mostly American. Some European countries require you to use one embryo at a time. The American Society for Reproductive Medicine is trying to make the same rule in the United States. The guidelines were updated recently and say that women with reasonable odds of success should be offered single embryo transfer and no more than two at a time Elder women may have two to three embryos since it is harder for them to conceive. Women are also required to be informed about the risks of multiple births and embryo transfers so this discussion should be noted in their medical records. Alan Copperman, medical director of Reproductive Medicine Associates of New York, confirms the purpose of these guidelines by stating, “In 2014, our goal is really to minimize twins.” The idea of “one at a time seems to be spreading. “Patients don’t really want multiples. What they want is high delivery rates,” says Richard T. Scott Jr., a physician and the scientific director for Reproductive Medicine Associates of New Jersey. There are new techniques to make success rates for single embryos nearly as good as the rate for when two or more are used. An example is maturing the embryos for a little longer to improve viability and allow cells to be sampled for chromosome screening. Chromosome testing and freezing adds about $4,000 to the approximate $14,000 cost of an IVF. But the pregnancy rates