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HFEA to consider single embryo limit

Dr. Kirsty Horsey

Progress Educational Trust

30 July 2005

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[BioNews, London]

The UK's Human Fertilisation and Embryology Authority (HFEA) is to review its rules on how many embryos can be implanted during IVF treatments. Currently, over 90 per cent of IVF cycles in the UK involve transferring two or three embryos to increase the chances of success. However, this also leads to a greater chance of multiple births, which carry a larger risk for both the mother and the children, and costs the National Health Service (NHS) up to 10 times more. Now the HFEA has announced that it will consider limiting IVF treatments to the transfer of a single embryo per cycle, as has been done in some other European countries.



The rates of multiple births are much higher for IVF patients, and twins or triplets are much more likely to be born prematurely or underweight and have an increased risk of physical and learning disabilities. Multiple pregnancies are also more dangerous for mothers, who are more likely to suffer serious complications like pre-eclampsia.



Angela McNab, chief executive of the HFEA, said: 'Women are designed to have healthy babies, one at a time, and with natural conception this is what usually happens. The HFEA wants to see the results of fertility treatment come closer to what occurs naturally'. The HFEA will canvass the views of fertility doctors and other professional organisations, plus patient groups during the review.



The Royal College of Obstetricians and Gynaecologists welcomed the review. 'There is no doubt that this is the way for the future and if we are serious about reducing the risk of multiple pregnancy it is the only option in practice', said a spokeswoman. 'There is now considerable experience from Finland, Sweden, Belgium and Holland where the introduction of single embryo transfer has been associated with a marked reduction in twin pregnancy rates but with no reduction in overall success rates', she added.



However, in most of those countries there is significant state funding for IVF. In Belgium, couples can get six free cycles and in Denmark it is five - while in the UK the NHS will at best only fund one cycle. As a result, many patients want to increase their chances of conceiving by having multiple embryos implanted rather than spend thousands of pounds on private treatment. 'There is still a severe lack of NHS funding for fertility treatment and we understand that some couples are willing to take these risks, particularly where they receive no NHS funding and can only afford to pay for one private cycle', warns Clare Brown, chief executive of Infertility Network UK.



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Reproduced with permission from BioNews, an email and online sources of news, information and comment on assisted reproduction and genetics.

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Date Added: 30 July 2005   Date Updated: 30 July 2005
Reviews (1)
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Shantal - Rajah   01 August 2005

I think making decision on single embryo transfer should be the patients who suffers infertility and pays for their treatment. When the HFEA cut down the number from 3 embryos to 2, many older patients (36 yrs - 39yrs) were upset and complained about the HFEA's ruling. Many older patients produce less number of eggs and embryos and they want to atleast 3 embryos transfered. Patients pay for HFEA (licence fee per cycle) and it should be consulted with patients and all UK treatment centres (NHS & Private). I have experience of few 39 yrs old patients felt very distressed not to have 3 embryos b'cos the HFEA ruling - only over 40yr old women can have 3 embryos. In April 2005, there was an article on this site saying women who go through IVF treatment wanted to have twins to complete their family at once. Few Medical experts agreed to that comment. I think this is unfair on IVF patients specially older women. Most of our centres do more cycles of IUI with clomid or mild stimulation. How can HFEA stop the twin pregnancy on IUI/DI patients? Clomid is prescribed by GP's to women for mild ovarian stimulation in natural cycle treatment. Can anyone stop having twins on these patients? It looks like IVF patients are targeted to reduce twin pregnancies or cut cost. In NHS, disasters and failures and complications can happen in any kind of operation or premature or normal deliveries (singleton/twin)and the cost can go up. I do not think the cut down number of embryo transfer from 2 to 1 in IVF patients going to save the NHS cost or stop complications.


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