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UK experts call to action on IVF funding and multiple births

5 February 2018
Appeared in BioNews 936

A report by the UK's Royal College of Obstetricians and Gynaecologists (RCOG) suggests that increasing government funding of IVF could decrease the number of multiple pregnancies and their associated strain on the NHS.

The scientific impact paper states that around one in five (19.8 per cent) of IVF  (in vitro fertilisation) deliveries in the UK in 2011 were multiple births.  Multiple embryos are sometimes transferred during an IVF cycle in an effort to reduce costs for patients funding their own treatment.

While the National Institute for Health and Care Excellence (NICE) currently recommends three fully funded cycles for IVF for all patients who meet set criteria, the number of cycles offered differs depending on where in the country patients live. In some regions, only one or no funded cycles are offered. Up to six in ten IVF cycles are being funded by patients themselves according to the RCOG study.

Professor Lesley Regan, president of RCOG, said: 'IVF is a cost-effective treatment and should be available on the NHS. Yet current access to treatment is a postcode lottery which is completely unacceptable for couples with infertility problems.

'Government funding for three full IVF cycles, as recommended by NICE guidelines, would provide a greater incentive for IVF centres and their patients to adopt single embryo transfer more regularly.'

Mr Tarek El-Toukhy, a consultant gynaecologist and specialist at Guy's and St Thomas's Hospital in London, and lead author of RCOG's report, said: 'The health and financial burden it places on women, families and the NHS cannot be overstated. To ensure rates of multiple births remain low, there is little doubt that the single most important factor that could enhance the acceptance of single embryo transfer among patients and practitioners is appropriate funding for IVF treatment.'

Multiple pregnancies pose risks to both the babies and mother with the chances of a premature labour six times more likely than a singleton pregnancy. Mothers of multiples have a higher risk of pregnancy-induced high blood pressure, gestational diabetes, haemorrhage following birth, and postpartum depression as well as heightened symptoms of anxiety and parenting stress.

Aileen Feeney, chief executive of Fertility Network UK, told The Guardian: 'For couples experiencing years of heartbreak in their struggle to have children, the decision to choose a single embryo transfer rather than a multiple embryo transfer can be a very tough one which is made even more difficult if they are facing the financially crippling costs of private IVF treatment.'

Efforts have been made to cut the number of multiple births in the UK, including promoting the benefits of single embryo transfer. The HFEA (Human Fertilisation and Embryology Authority) has found a reduction in the national multiple birth rate from 24 percent in 2009 to 11 percent today.

SOURCES & REFERENCES
Doctors urge end to IVF postcode lottery to reduce multiple births
The Guardian |  2 February 2018
Full funding of IVF treatment would lower rates of multiple pregnancies, says RCOG
Royal College of Obstetricians & Gynaecologists |  2 February 2018
Fully funding IVF would improve safety for mothers, experts say
BBC |  2 February 2018
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