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HFEA squeezes multiple birth limit to 20 per cent

1 February 2010
Appeared in BioNews 543

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.

The decision was made during a meeting on the 20 January 2010 when the first year of the policy was evaluated. The authority reviewed feedback from patients and clinics and analysed the likely impact on clinics and overall birth rates, before setting the new rate. The HFEA says 20 per cent will maintain the momentum clinics have built up over the past year, but will give them time to review and improve their strategies for reducing multiple rates further.

The HFEA's policy is designed to promote the health benefits of having a single baby without reducing a woman's chances of IVF success. It aims to reduce the number of multiple births to ten per cent over three years. The HFEA says the policy is based on a growing body of evidence showing clinics can maintain their overall live birth rates while reducing the risk of multiple births. This can be done by selecting suitable patients for single embryo transfer and including subsequent frozen embryo transfers in a complete cycle of treatment.

Multiple births are the single biggest health risk to mothers and babies following assisted conception, according to the HFEA. At present about one in four IVF or  ICSI (intracytoplasmic sperm injection) conceptions results in twins. Therefore, after IVF or ICSI, a woman is 20 times more likely to have twins than if she conceived naturally.

The health risks for twins and triplets are higher than singletons because they are often born prematurely and underweight. IVF twins need more specialist care around birth and risk lifelong poorer health. Mothers carrying twins risk a range of conditions compared with mothers carrying singletons, including miscarriage, gestational diabetes, induced hypertension and preeclampsia.

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