April 3, 2007

launch of HFEA consultation on multiple births

The Science Media Centre asked fertility experts to comment on this story.

Mr Yacoub Khalaf, Reproductive Medicine Consultant and lead clinician for the assisted conception unit at Guy’s and St Thomas’ NHS Foundation Trust, said:

“We are already achieving great successes by replacing only single embryos in many of our suitable patients. In the last year our overall pregnancy rate has risen and our multiple pregnancy rate has been reduced. This is a result of our programme to extend the amount of time the embryo is incubated – from three days to five – before being implanted. This extra incubation time allows us to be more confident of the quality of the embryo before it is replaced and is allowing us to produce more successful pregnancies from single embryo transfers.

“Where it is possible, and clinically appropriate to do so, we always advise on the replacement of a single embryo. However, we discuss all the options and risk factors with each couple to ensure they get the best treatment for them whatever their individual circumstances.”

Dr Simon Fishel, Managing Director, CARE Fertility Group, said:

“Having a standard percentage target is a tactic that has been used for other aspects of IVF treatment over the years, so this element is not a surprise. A clinic can use good clinical judgement to meet the needs of the individual patients and responsible practitioners already limit the number of multiple births in this way.

“My only two concerns are, firstly that there will be groups of patients compromised due to the funding scenario in this country; we need to do as much as we can to persuade government to abide by NICE recommendations. Secondly, the way the HFEA report their data will put additional pressure on clinics because they report outcomes based on treatment cycles started. It would be sensible to review this in the light of single embryo transfers.”

Dr Mohamed Taranissi, Medical Director of the Assisted Reproduction And Gynaecology Centre, said:

“There are risks associated with multiple births and I agree that it’s right to try to reduce these. However we first need to address the issue of how to improve the overall birth rate from IVF in the country as a whole. A 10% restriction on multiple births would be a real problem for clinics with a success rate of around 10%. There are a number of techniques that we could be using to improve the birth rate – including better monitoring of patients, allowing the fertilised egg to grow in the lab for longer to select the eggs most likely to survive in the womb and so on. When we have improved these techniques and can offer people a better chance of having a baby then we can move onto adressing the real challenge of reducing multiple births.”