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Single embryo transfer recommended to cut IVF multiple births

10 April 2007
Appeared in BioNews 402

The UK's Human Fertilisation and Embryology Authority (HFEA) has launched a consultation to find the best way to reduce problems experienced by IVF children arising from multiple births.

According to the HFEA, as IVF has become more successful, the number of multiple births has increased. Currently around 40 per cent of IVF babies are twins, and therefore three times more likely than single babies to be stillborn. IVF twins are also at a greater risk of being born prematurely, require more specialist care at the start of their lives, and are at risk of experiencing poorer health throughout their lives. HFEA chair Shirley Harrison stated, 'The latest figures show 126 IVF babies die each year because they have been born as twins not single babies. We can't let that continue'.

The HFEA consultation aims to find the most effective way of preventing multiple births, while still giving women the maximum chance of IVF success. The consultation follows a report issued last year by a group of experts, led by Professor Peter Braude, from Kings College London. The report found that IVF children must be given a better chance of being born healthy, full-term, as single babies, and at a normal birth weight. The group recommended the safest way to protect IVF babies from those risks was to move towards single embryo transfer (SET) in women with the best chance of IVF success.

Patient groups have argued that women request multiple embryo transfer because most primary care trusts have refused to follow government guidelines, which would entitle women under 40 to three cycles of IVF treatment on the NHS. The refusal to grant treatment is mostly due to financial pressures, but results in a varied provision of IVF treatment across the country. Clare Brown, chief executive of Infertility Network UK, commented that imposition of SET would require 'implementing the NICE (National Institute of Health and Clinical Excellence) fertility guidelines in full, allowing couples to receive up to three full NHS cycles of IVF, including frozen embryo transfer'. Ms Brown has urged patients to lobby their MPs for NHS funding in order to end the 'postcode lottery' that exists in the provision of IVF treatment.

The HFEA has proposed four guidelines to help fertility clinics reduce the number of multiple births. The guidelines propose encouraging the use of SET, introducing a maximum twin rate per clinic of 10 per cent, developing HFEA guidelines as to when single embryo transfer should be used, and recommending the HFEA guidelines for single embryo transfer should be used if the 10 per cent twin rate is exceeded by a clinic.

Under current IVF practices clinics can implant up to two embryos per cycle for women under 40 and up to three for women over 40. There are no plans to prevent this continuing in some cases. However, younger women, who have a high chance of IVF success, may be restricted to SET.

SOURCES & REFERENCES
Childless couples to face new IVF hurdle
The Times |  4 April 2007
Fertility watchdog seeks to reduce twin births
Reuters |  4 April 2007
Multiple births and single embryo transfer review
HFEA |  4 April 2007
Twin IVF births 'need to be cut'
BBC News Online |  4 April 2007
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