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Our campaign to reduce multiple births

Multiple births are the single greatest risk of fertility treatment. But they can be avoided without affecting the birth rate. Our campaign, One at a Time, aims to raise awareness amongst patients and professionals to ensure that as many women as possible have a healthy baby. Find out more about the campaign and what we’ve achieved.

One at a Time logo

Campaign aims

We launched One at a Time in 2007 to tackle the high multiple birth rate following IVF - one in four births were multiple births at that time – 20 times higher than natural conception. Multiple pregnancies and births are riskier for the mother and her babies – and if there is a problem, the effects are sometimes lifelong.

We met our multiple birth target of 10% for the first time in 2017, having reduced from 24% in 2008. For the latest statistics on multiple births, visit our Research and data page.

The campaign is part of a national collaboration between us as the regulator and patient groups, fertility professionals, neonatal experts and commissioners. Together, we work to:

  • share best practice and develop professional guidance
  • publish information for patients and professionals about multiple births and single embryo transfer
  • improve NHS provision of fertility treatment

If you are a patient and want to know more about how to avoid a multiple birth, have a read of our information on embryo transfer.

Our policy around multiple births

Besides our campaign to raise awareness, we have an outcome-based regulatory policy to reduce multiple births.

We set a maximum multiple birth rate target and allow clinics to develop their own strategy for reducing their multiple birth rate to meet that target. Clinics can choose the approach that suits their practices and patients, whilst giving them something to aim for.

Our inspectors monitor each clinic’s progress and give them early warning if they are likely to miss the target. The inspector and the clinic work together to bring the rate down.

How does the policy work?

  • We have an overall goal to reduce the national multiple birth rate to 10%.
  • We set a maximum multiple birth rate that clinics must not exceed, which has been lowered each year since 2009.
  • Each clinic has its own ‘multiple births minimisation strategy’, setting out which patients qualify for single embryo transfer in that clinic.
  • We monitor and inspect clinics to make sure they are working towards the target.

How have fertility clinics done?

The fertility sector as a whole has responded very well to the drive to reduce multiple births.

Visit Choose a fertility clinic to see each clinic’s multiple birth rate

Read our Fertility Trends report for national data on multiple births

How have clinics reduced their multiple birth rates? Since the introduction of the policy in January 2009, clinics have increased the number of patients having elective single embryo transfer (eSET) – they pick one embryo rather than two.

The number of eSETs as a percentage of all embryo transfers has continued to increase year on year, which has led to a considerable decrease in the multiple pregnancy rate across all age groups. In the right patients, the pregnancy rate from elective single embryo transfer is similar to the pregnancy rate from double embryo transfer. And the multiple birth rate is much lower.

History of our multiple births policy

In 2005, we commissioned a group of fertility and public health experts to report on the risks of multiple births from fertility treatment.

Read the ‘One child at a time’ report

In 2007, we ran a public consultation on how we could regulate to bring down the multiple birth rate.

Read the consultation document, ‘The best possible start to life’

In 2009, our board agreed its outcome-based policy.

Read the board paper

In 2011, we published a statistical report on the progress that the fertility sector had made to reduce multiple births. We published updates in 2015 and 2022.

Read the latest statistical report

Review date: 15 December 2025