For over 30 years, perinatologists and healthcare professionals have sought to reduce the morbidity associated with multiple pregnancies, particularly those resulting from artificial reproductive technologies (ART). Significant efforts in national and professional settings to mitigate these risks by increasing the rate of single embryo transfers and the incidence of multiple pregnancies have led to a significant improvement in multiple pregnancy reduction but still remain relatively high among ART patients. This situation poses risks to both mothers and newborns and contributes to the economic burden of prematurity.This review aims to present the latest evidence on single embryo transfer, guiding decision-makers and enhancing patient understanding to support an elective policy aimed at reducing the risk of twinning. Implementing single embryo transfer can further lower the incidence of multiple pregnancies while preserving patient autonomy and the right to choose.