IVF rationing ‘could cut risk of multiple births’

[cezene]

IVF treatment could be rationed under new rules to be considered by the fertility treatment regulator.

The Human Fertility and Embryology Authority (HFEA) is set to start a public consultation about whether only one embryo, rather than two, should be implanted in patients. The authority believes that it will cut the number of multiple births and protect the health of mothers and babies.

Fertility specialists say that it will severely reduce the odds of successful conception. About 30,000 women each year in the UK turn to IVF after failing to conceive naturally. In most cases two embryos are implanted with each cycle of treatment to increase the chances of pregnancy. But a report by an independent group published last year suggested that the huge rise in multiple births put the health of mothers and babies at far greater risk.

One key proposal of the One Child at a Time report was to set criteria for selecting first-time IVF patients who would be offered single embryo transfers only. These would be the youngest, healthiest patients at highest risk of multiple pregnancies.

Such pregnancies carry much higher risks of miscarriage, preeclampsia and birth complications, while twins, triplets and other babies who have shared a womb together are more likely to be born prematurely.

Unlike natural conception, where the chance of a multiple birth is relatively low (1 delivery in 80 is of twins), the latest figures suggest that almost a quarter of IVF pregnancies result in multiple births, accounting for half of the 10,000 such births each year in the UK.

Women who undergo IVF treatment are currently limited to two embryos under rules introduced by the HFEA in 2003. Since then, the incidence of triplets is thought to have more than halved. But cutting the number of embryos implanted in each IVF patient also reduces the already low chances of the treatment working at all, meaning that a woman may need more or repeated cycles.

Last year’s report said research had found that implanting only one fresh embryo in the first IVF cycle for women under 34 cut pregnancy rates to 38 per cent from about 75 per cent when two were implanted at the same time.

It has been suggested that under the revised rules, doctors should still be able to use their clinical judgment to decide if a woman should get two embryos, but that clinics will be told to reduce the number of multiple births through IVF from 25 per cent to 5 to 10 per cent.

This could be achieved only if half or more women were limited to one embryo.

The HFEA said yesterday that a decision was not expected to be taken until the autumn.