Multiple pregnancies spontaneously occur in one out of 90 pregnancies for twins and in one out of 8,100 for triplets. However, since the introduction of human reproduction units, there has been a 52%increase in twins, and a 404%increase in high-order pregnancies. Given the high perinatal and maternal morbidity and mortality in these pregnancies, selective embryo reduction was developed to increase fetal survival and reduce long-term morbidity in neonates. Although effective, this procedure represents a technical and ethical challenge for the practitioner. Consequently, we believe that the most effective approach to multifetal pregnancies is primary prevention.