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King's College London - Health: More than a medical matter





Senior IVF doctor declaims 'serious health risk' of ovarian stimulation

21 May 2012

By Greg Ball

Appeared in BioNews 657

A senior IVF doctor has voiced concerns over health risks to women in IVF treatments that are commonly practiced by UK clinics.

Ovarian stimulation - where drugs are used to stimulate the production of eggs - is frequently employed during IVF in the UK. But the technique carries a health risk and can engender serious or even fatal complications. Some studies suggest that embryos produced from eggs released during ovarian stimulation carry a higher risk of abnormalities.

These concerns were discussed at the conference of the International Society for Mild Approaches in Assisted Reproduction (ISMAAR) in Copenhagen. Professor Geeta Nargund, President of ISMAAR and Head of Reproductive Medicine services at St George's University Hospital, London, told the conference: 'High-dose stimulation can have distressing side effects on the woman, the most serious of which is called ovarian hyper-stimulation syndrome (OHSS). A recent confidential inquiry into maternal deaths in the UK showed that OHSS was now one of the biggest causes of maternal mortality in England and Wales. There is no doubt that women subjected to this kind of stimulation are at serious health risk'.

The Independent reported figures obtained under the Freedom of Information Act from the Human Fertilisation and Embryology Authority (HFEA). Thirty thousand cases of OHSS were recorded between 1991 and 2007, with symptoms ranging from chest pains and shortness of breath to kidney failure.

Professor Nargund, who in a recent slot on Channel 4's 4Thought TV programme described herself as 'a campaigner for women's health and safety in fertility treatment', is supported by others in the field. Professor Ian Cooke, Chief Executive of the Low Cost IVF Foundation told the Independent: 'We are over-stimulating women, driving the cost up and the complications up. The first aim should be to reduce complications'.

The mild IVF technique uses less harmful drugs to stimulate the ovaries, producing fewer eggs and having lower pregnancy rates per cycle. However there is a quicker recovery time compared to standard IVF with treatment able to be repeated within a month. Professor Nargund told the conference: 'We could double the number of patients treated at no extra cost and the complications would be less'.

Fertility clinics in Canada, Japan, South Korea, Scandinavia and several European countries have adopted the mild IVF approach, while in the US and the UK high-dose IVF is preferred.

Nonetheless, there are doubts regarding the success rates of mild IVF. Susan Seenan, deputy chief executive of the Infertility Network UK said: 'The first thing women will want to know is: what are their chances of a baby with mild IVF? If patients have to undergo multiple cycles it might mean more disappointment and upset'.

A spokesman for the HFEA commented: 'There is currently no data which we hold that is an accurate marker of poor clinical practice or is a predictor for the likelihood of a patient experiencing OHSS. The HFEA continues to monitor this research'.

 

SOURCES & REFERENCES
4Thought TV (Channel 4) | 13 May 2012
 
Independent | 14 May 2012
 
Professor Geeta Nargund, Medical Director
Create Health (biography) |
 
Mail Online | 14 May 2012
 
ISMAAR |
 
Daily Telegraph | 14 May 2012
 

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