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HFEA code aims to bring an end to triplet births

7 January 2004
By BioNews
Appeared in BioNews 240

The UK's Human Fertilisation and Embryology Authority (HFEA) has published a revised Code of Practice, the sixth since the establishment of the authority in 1991. The code provides guidelines for HFEA-licensed fertility clinics on the provision of IVF and related services. The most significant addition to the new edition of the Code of Practice, which replaces the fifth code published in March 2001, concerns the numbers of embryos that can be transferred to a woman during IVF treatment. The new guidance stipulates that clinics should transfer no more than two eggs or IVF embryos at a time to women under 40 years old and no more than three eggs or embryos to women older than 40.

The HFEA says that there should be no exceptions to this rule and that clinics which fail to comply with the guideline may risk losing their licence. The new Code is accompanied by an information leaflet designed for patients, aiming to highlight the medical and psychological problems associated with multiple births. Jane Denton, Director of the Multiple Births Foundation and member of the HFEA, emphasised this, saying: 'Multiple births are associated with premature and low birth-weight babies and the risk of [a baby's] death before birth or in the first week of life is significantly greater. Compared with one baby, the risk of long term disability like cerebral palsy is around five times higher for twins and 18 times higher for triplets.'

Statistics show that nearly half of all triplet births in 1999 were as a result of fertility treatment and there continue to be large numbers of twins and triplets born from IVF. Previous HFEA recommendations, issued in August 2001, that three embryos should be transferred to the womb only in exceptional circumstances, have started to reduce multiple birth rates. However, Suzi Leather, chair of the HFEA, said that the HFEA's aim 'is to bring the number of multiple births from fertility treatment closer to that which occurs naturally'. She added 'In most women, limiting the amount of embryos [transferred] has a significant impact on the number of multiple births without reducing their chance of having a baby'.

These new restrictions have been welcomed by the British Fertility Society, Multiple Births Foundation and Royal College of Obstetricians and Gynaecologists (RCOG). Professor Allan Templeton, honorary secretary of the RCOG, said that because multiple births involve risks to both mothers and children, and place a burden on neonatal care services, 'every attempt should be made to avoid multiple births, particularly triplets, in IVF treatment'. He added that the RCOG would also like 'more work done to reduce the number of twins born'.

But not everyone welcomes the new guidelines. Dr Mohammed Taranissi, director of the Assisted Reproduction and Gynaecology Centre in London told the BBC: 'This is not a law. These are only guidelines. If I believe honestly that this is not in the best interest of patients I will do what I think is fit.' Professor Ian Craft, director of the London Fertility Centre, said 'I'd say that a significant number of women will be prevented from having their own biological child as a result of this code of practice'. 'That is a serious accusation', he added. The Code of Practice, which was laid before parliament on 6 January, will come into effect on 1 March 2004.

IVF clinics told to limit embryo implants to curb multiple births
The Guardian |  7 January 2004
IVF rule 'will stop women getting pregnant'
The Sunday Herald (Scotland) |  4 January 2004
Limits on number of IVF embryos in move to cut multiple births
The Scotsman |  7 January 2004
New restrictions to cut multiple births in IVF treatments
The Independent |  7 January 2004
6 February 2006 - by BioNews 
A new study on the effect of single embryo transfer (SET) on pregnancy rates has triggered further calls for the UK's Human Fertilisation and Embryology Authority (HFEA) to stick with its existing policy on this issue. The research, published in the journal Human Reproduction, shows that imposing a single embryo...
16 January 2006 - by Professor William L Ledger 
Many years ago the then Minister of Health, Frank Dobson, drew attention to the unfairness of the 'postcode lottery' of provision of infertility treatments in the UK. Following his initiative, a subsequent Minister, Alan Milburn, later commissioned the National Institute for Health and Clinical Excellence (NICE) to look into this...
16 January 2006 - by BioNews 
UK researchers say that an additional 10,000 cycles of IVF per year could be provided free on the National Health Service (NHS), if clinics took action to reduce the number of multiple births following IVF. It is common for women undergoing IVF to have two embryos implanted at a time...
21 October 2005 - by BioNews 
Figures released this week by the International Committee for Monitoring Assisted Reproductive Technology (ICMART), show that IVF success rates in America are almost double those in Europe. The finding was reported at the American Society for Reproductive Medicine (ASRM) conference that took place in Montreal, Canada. American fertility specialists pointed...
20 August 2005 - by Professor Ian Craft and Dr Alan Thornhill 
The UK's Human Fertilisation and Embryology Authority (HFEA) recently announced that it is to review its rules on how many embryos can be implanted during IVF treatments. Transferring fewer embryos to all patients inevitably results in fewer multiple pregnancies, and we fully support measures making IVF safer. However, we recommend...
13 August 2001 - by BioNews 
Patients undergoing IVF treatment in the United Kingdom will be allowed to have no more than two embryos transferred to the womb, following an announcement by the Human Fertilisation and Embryology Authority (HFEA). The authority is concerned about the high rate of twins and triplets births following IVF, a rate...
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