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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.

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
1 February 2010 - by Rose Palmer 
The UK's Human Fertilisation and Embryology Authority (HFEA) has set a 20 per cent maximum multiple birth rate for fertility clinics. Last year's maximum rate - the first since the HFEA's multiple births policy was introduced - was 24 percent. The new rate will become effective from 6 April 2010....
26 February 2008 - by Dr Rebecca Robey 
Scientists at a UK fertility clinic have reported that a new IVF technique may increase the rate of pregnancy whilst decreasing the risk of multiple births. The study, published in the British Journal of Obstetrics and Gynaecology, involved nearly 2500 women over a three-year period and found...
10 December 2007 - by Dr Kirsty Horsey 
The UK's Human Fertilisation and Embryology Authority (HFEA) called last week for a new national strategy designed to reduce the number of multiple births from fertility treatments, as a result of which it expects to see the multiple birth rate to fall to 10 per cent...
20 August 2007 - by Ailsa Stevens 
Women with fertility problems would rather take the risks associated with multiple pregnancies than risk not becoming pregnant at all, reveals research published in BJOG: An International Journal of Obstetrics and Gynaecology (BJOG) this month. Researchers from the University of Aberdeen surveyed a total of 74 women...
13 August 2007 - by Danielle Hamm 
A survey conducted by the Infertility Network UK (I N UK) and sponsored by the UK Department of Health (DH) has shown that the provision of IVF treatment in the UK does not meet government guidelines. The survey indicated that provision of NHS fertility treatment is patchy...
21 October 2006 - by Dr Kirsty Horsey 
An expert panel commissioned by the UK's Human Fertilisation and Embryology Authority (HFEA) has issued a report recommending that new guidelines should be introduced to limit the number of embryos which can be implanted during in vitro fertilisation (IVF) cycles. The HFEA last reviewed its guidelines...
16 October 2006 - by Dr Jess Buxton 
The interim chairman of the UK's Human Fertilisation and Embryology Authority (HFEA), Lord Harries of Pentregrath, has said that there should be no upper age limit for women seeking IVF treatment. In an interview with the Times newspaper, the former Bishop of Oxford, Richard Harries, said...
25 September 2006 - by Dr Kirsty Horsey 
The UK's fertility treatment regulator, the Human Fertilisation and Embryology Authority (HFEA), is likely to recommend that women undergoing IVF treatment should only be allowed to have one embryo transferred at a time. The HFEA last reviewed its guidelines on how many embryos can be implanted...
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 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...
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