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expert reaction to Human Fertilisation and Embryology Authority (HFEA) 2013 fertility trends report

The Human Fertilisation and Embryology Authority (HFEA) has published its report into trends in fertility in the UK.


Dr Yacoub Khalaf, Honorary Senior Lecturer, Guy’s and St Thomas’ NHS Foundation Trust, said:

“It is great to see the multiple pregnancy rates falling whilst the overall success rates are maintained. This finding resonates with our experience at Guy’s Hospital and is reassuring as multiple pregnancies carry higher risks to both mothers and children.”


Ms Sarah Norcross, Director of the Progress Educational Trust, and Co-chair of Fertility Fairness, said:

“It is disappointing that yet again, the number of people who are able to access fertility treatment on the NHS has remained static at around 40%, and that that the proportion of people who are able to access treatment in England will be significantly lower than that. In Scotland there is a much higher percentage of NHS-funded IVF cycles, with many more patients able to access up to three full cycles. This will have distorted the picture for people living in England, where there are huge variations in provision.”


Dr Allan Pacey, fertility expert, University of Sheffield, said:

“This is a useful update from the HFEA on assisted conception cycles undertaken in 2013. The data shows that treatments such as IVF are now very much in the mainstream of UK medical practice and is now performed more frequently than other well-know procedures such as having tonsils removed (there were 47,141 of those in the NHS in 2012-13). Therefore, it remains disappointing that in many parts of the NHS Assisted Conception is still a Cinderella Service with the NICE funding guidance being ignored and many patients having to pay for their own treatment.

“On a more upbeat note, the report also shows the continued coordinated efforts of professionals to reduce the number of multiple births which can occur as a consequence of IVF. Whilst twins and triplets may seem like an instant family, health outcomes for children are better if they are born “one at a time”. There has been a paradigm shift in IVF in recent years with increased emphasis on elective single embryo transfer for increasing numbers of patients and it is gratifying to see that strategy working and paying dividends.”


Mr Richard Kennedy, President of the British Fertility Society, and President Elect of the International Federation of Fertility Societies, said:

“The continued downward trend in multiple pregnancy is very welcome and has been achieved without a reduction in overall live birth rates. This is in line with the Swedish experience and supports the current UK strategy.”


Prof. Daniel Brison, Scientific Director, Department of Reproductive Medicine, Central Manchester University Hospitals NHS Foundation Trust, and Professor of Clinical Embryology, University of Manchester, said:

“It is very encouraging that live birth rates from IVF treatment remain stable while multiple birth rates are declining as a result of increased use of single embryo transfer.  It is also good news that the use of embryo freezing is increasing and success rates are also increasing, as this gives patients the best chance of a pregnancy from each IVF cycle and encourages single embryo transfer.  However the report also shows that the majority of embryo transfers in 2013 continued to replace more than one embryo and multiple birth rates at 16% are still too high, so there is still work to be done to promote safe practice in IVF.”


Prof. Darren Griffin, Professor of Genetics, University of Kent, said:

“The report raises a number of interesting issues and challenges. Given the large proportion of children born by IVF in countries such as Denmark and Australia it seemed certain that the UK would move in a similar direction. The UK has continued to lead the world not only in the science and medicine of IVF but in considering the ethical, legal and social policy issues that underpin it. I thus feel optimistic that it will continue to do so and issues such as the increase in donor eggs for older women and treatments for same sex couples will be considered and debated fully. The “one at a time” campaign is a process that will not be fully delivered overnight but the data shows that it is clearly having an effect and moving in the right direction. Because of the obstetric complications associated with multiple births, this is to be welcomed.”


Prof. Sheena Lewis, Chair of British Andrology Society, and Professor of Reproductive Medicine, Queen’s University Belfast (QUB), said:

“It is very disappointing that success rates have not improved, yet again. In my opinion, one of the reasons for the low success rate is an unsatisfactory diagnosis of the male partner. We should test the man’s sperm at a molecular level, looking at his sperm DNA quality to help guide couples to the best treatment for them.”


Declared interests

Dr Yacoub Khalaf is also Consultant Gynaecologist & Sub-Specialist in Reproductive Medicine and Surgery at Guy’s and St Thomas’ NHS Foundation Trust and Director of the Assisted Conception Unit & HFEA Person Responsible.

Mr Richard Kennedy is also Executive Director, Women’s and Newborn Services, Royal Brisbane and Women’s Hospital; and Adjunct Professor, University of Queensland.

Prof Daniel Brison is a member of the HFEA’s Scientific and Clinical Advances Advisory Committee (SCAAC) and an advisor to their Information for Quality (IfQ) Programme, which is concerned with publication of IVF success rates among other things.

Prof. Darren Griffin is director of the Centre for Interdisciplinary Studies of Reproduction (CISoR) –

Prof. Sheena Lewis is:

Chair of British Andrology Society,

Member of British Fertility Society Exec committee and co-author of BFS guidelines in Andrology,

UK representative of European Society of Human Reproduction and Embryology ESHRE,

CEO of Lewis Fertility Testing Ltd.



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