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... Although extended embryo culture and blastocyst transfer are often considered as a way to " naturally select " embryos (Sepúlveda et al., 2011), this strategy has a low efficiency in identifying euploid embryos for transfer. In America, individual states can develop unique public health insurance programmes which may be used as experimental models influencing the entire nation (Larson & Williams, 2003; Romney, 2007). The present analysis is the first to demonstrate how a social health investment by California in IVF, aCGH from embryos biopsied on day five, and fresh SET being can be more than recovered by downstream savings, because health spend is conserved when costs of higher-order multiple gestation deliveries are avoided in favour of singleton births from IVF. ...