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HFEA calls for national strategy to reduce the biggest risk of fertility treatment - Multiple births |
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Tuesday, 04 December 2007 |
 HFEA Logo
An increased rate of twin births represents IVF's biggest risk for mothers and babies because they significantly raise the chances of mortality, prematurity, low birth weight and cerebral palsy for babies. It can also cause life-long term problems for children and risks to mothers, including preeclampsia, diabetes and heart disease.
Following the HFEA's public consultation on the best outcome for IVF babies, the Authority have concluded that they expect to see the multiple birth rate to fall to 10% following a 3 year national strategy.
The Authority have now called on the relevant professional bodies to lead on developing guidance on the best way to achieve this change across all types of fertility treatment, including those which fall outside the HFEA's regulatory system.
A recent study has shown that the rate of multiple births and the risks they bring to women and babies is disproportionate for all types of fertility treatment, but especially IVF. Although IVF treatment accounts for only 1.2% of all UK births, it accounts for nearly 1 in 5 of the multiple births in the UK.
Other fertility treatments have also been shown to contribute to a higher incidence of multiple births, including IUI, GIFT and drugs for ovarian stimulation. As some of these treatments fall outside the HFEA's remit, the Authority are calling for a national strategy, co-ordinated by the professional bodies to set out guidance on best clinical practice during treatments which cause a higher rate of multiple births.
Work on this strategy is due to begin in mid December, to begin the challenge of finding the best long term strategy for clinics to bring down their multiple birth rates. The progress of this work will be discussed at the Authority's open meeting in February 2008.
Walter Merricks, Interim Chair of the HFEA said:
"This issue about improving baby health and safety. Maximum safety means the way the body was designed, one baby at a time. As many as 126 IVF babies die each year as a result of being born as part of a multiple birth and many more can face serious health problems which can last a lifetime.
"We are not in the business of intervening in the decisions made between a patient and their doctor or sacrificing women's chances of conception by asking clinicians to force women to have treatments that offer low chances of success. But this is a real problem that has to be addressed.
"The HFEA's latest clinic data has shown a slight increase in 2005 in the proportion resulting in both twin and triplet births following IVF, compared to 2004. It is clear that the increasing success of IVF is driving the number of multiple births up instead of down
"But the issue of multiple births and the problems that they can provide is bigger than just IVF and, therefore, bigger than just the area which the HFEA can influence. IUI, GIFT and drugs for ovarian stimulation also contribute to a higher incidence of multiple births. This is why we are calling for a co-ordinated, long term, national strategy to tackle this issue over time.
"The principles of good medical practice in this country are that it is evidence-based and professionally led. This issue is no exception - the profession needs to lead the way and the HFEA will do everything it can to support that.
"This approach means that the experts in this sector who treat patients every day will be able to decide on the detail of how this risk is reduced in a way that is workable for clinics and patients. This will take time, but we applaud the commitment shown already by the professional bodies and look forward to working closely with them to improve baby safety following IVF."
- To read Walter Merricks (Interim Chair of the HFEA) speech on “Improving baby safety by reducing multiple births” please go to http://www.hfea.gov.uk/docs/mulitple-births-speech.pdf
- To read the British Fertility Society’s press release welcoming the announcement made today by the HFEA please see below.
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British Fertility Society response to the HFEA calls for national strategy to reduce multiple births |
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Tuesday, 04 December 2007 |
Dr Mark Hamilton, Chair of the British Fertility Society said:
“The BFS welcomes the announcement of the HFEA today which recognises that multiple birth rates after assisted reproduction treatment are high. The BFS responded to the HFEA consultation on multiple births earlier this year and the concluding remarks within the Society’s response were as follows:
The evidence base linking the practice of multiple embryo transfer and the consequent achievement of pregnancies at significantly greater risk of serious neonatal and maternal complications is well known. All the major risks of morbidity and mortality are significantly increased for twins compared with singletons. The BFS strongly believes that the health benefits to children, the reduction in distress for families and the enormous cost savings for society, through reduction in the need for immediate and long-term health care for affected children, make an overwhelming case for change in this area of clinical practice. This view was shared in a recently published Consensus Statement (Human Fertility, 10:71-74 (2007)). Modification of embryo transfer policy through careful patient and embryo selection can significantly reduce the risk of twins after IVF. A balanced approach will allow clinicians to take into account the individual circumstances of any given patient without compromising the chances of conception.
There is broad support within BFS membership for initiatives which can remedy the current high numbers of multiple pregnancies after IVF. As providers of treatment we need to be seen to support the principle of offering the best for patients taking into account their individual circumstances as they progress through treatment.
The BFS believes that an approach where the regulator provides clinics with targets for multiple rates, expressed as a percentage of all pregnancies created, is sensible, allowing clinics themselves to determine how best to reform practice to achieve this end. It is reasonable for the Authority to provide guidance in this regard. The BFS would not favour an approach at this stage which was absolutely prescriptive as this would not prove popular with patients or clinics.
There is an urgent need for an adequately resourced public/professional education initiative to promote effective and safe embryo transfer policies. Over the next year the goal must be to change the national mindset around appropriate embryo transfer numbers. Furthermore the regulator absolutely must adopt an active role in promoting sound commissioning practice including adequate adoption by PCT’s of the NICE Guidelines relevant to IVF cycle definitions and numbers.
It is only through a dual approach whereby we encourage good practice and empower patients and professionals in decision making with reliable, understandable information that we can expect progress to be made.
The BFS looks forward to working with the regulator in advancing the safe delivery of care to the maximum number of people seeking fertility treatment in the United Kingdom.”
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Love Ladder - FF's Relationship game! |
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Wednesday, 21 November 2007 |
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Fertility treatment can put any relationship to the test - even some of the strongest bonds find it hard to survive the torture that tx puts us through. We have thought about this and think we have found a way to help spice up the day to day drag of infertility. Over the coming weeks, we will be issuing challenges to members - each challenge will be a step on our love ladder. The bottom steps will be very simple (but fun) and the top of the ladder will be some pretty hot challenges. The challenges have been designed to not only spice up your relationship - but also to help develop it and learn about each other. Challenges include a mixture of things including Soul diving, inquisition, race to romance, creative writing, cuddles - kisses and giggles plus lots more. |
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