Fertility regulator launches public consultation to find best ways of reducing the proportion of multiple births after IVF

 
The Human Fertilisation and Embryology Authority (HFEA) is launching a public consultation on April 4 to find the best way to reduce avoidable problems for IVF children and their mothers who can suffer serious and long-term complications from twin births.

The HFEA will be listening closely to patients and professionals over the next three months to find the best way of reducing the proportion of multiple births after IVF. The key aim is to find the most effective way to do this whilst still allowing clinicians to tailor their treatment to each woman's individual circumstances and without prejudicing her chances of IVF success. Public meetings for both patients and clinicians will be held during the consultation to allow debate and further feedback into the consultation.

The consultation paper proposes four main options to help clinics reduce multiple birth rates:

• Increasing awareness of multiple births risks among clinics and patients and encourage increased use of single embryo transfer
  
  
• To phase in a maximum twin rate of 10% which clinics must not exceed
  
  
• To develop HFEA guidance to define when only one embryo should be replaced
  
  
•  To apply HFEA guidance for single embryo transfer if clinics exceed twin rate of 10%

The consultation follows last year's report by a group of experts, including fertility clinicians and patients, chaired by Professor Peter Braude from King's College London. The group agreed that IVF children must be given a better chance to be born as healthy, full-term, singletons with a normal birthweight. The Braude report further recommended that the only safe way to reduce the risk for IVF babies was to move towards transferring one embryo in those women with the best chance of IVF success. This would not mean that all women would have a single embryo transferred or that double embryo transfers will be banned.  Instead, they suggested that a woman with a good chance of IVF success should have her embryos implanted one at a time, with frozen cycles following the initial fresh transfer, to reduce the risk multiple births pose to herself and the children she might carry.

A number of key professional bodies and patient organisations are expected to participate in the public consultation and the meetings to give their views on the best way to make IVF safer. The consultation is due to report in Autumn 2007.

Shirley Harrison, Chair of the HFEA, said:

"We know that multiple birth is the single biggest risk of IVF. "It is our primary job as a regulator to make sure that IVF treatment is safe and appropriate. We want clinics to reduce multiple births and minimise the risks for both mothers and the children they are carrying.

"The most important thing that we are looking for in this consultation is to find a solution that is workable in practice for all involved. Proper consultation is much more than just presenting the issues, it is about listening to the views of a wide range of people so that we can work together towards the best possible outcome for mothers and their children.

"This consultation will be about finding a way to reduce the risk of multiple births without prejudicing women's chances of IVF in a way which doctors feel they can work with whilst still tailoring their treatment to the individual circumstances of each patient they see."

The consultation document is available here: http://www.hfea.gov.uk/en/483.html 

FAQs - Multiple births consultation : http://www.hfea.gov.uk/en/1510.html

Further online dicussion here : http://www.fertilityfriends.co.uk/forum/index.php?board=205.0 

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There have been a lot of stories in the media over the past few days claiming that the HFEA will be 'imposing' some sort of 'rationing' of IVF treatment.

This is because, on Wednesday, the HFEA will be launching a three-month consultation on the best way to tackle the biggest risk of IVF for mothers and babies - the problem of multiple births.

The HFEA has not made any decisions and is not committed to any particular approach to tackling the problem. We know that this is a difficult and sensitive area for patients which is why we are holding a three-month consultation on this issue.

The media coverage on this issue over the last days is based purely on speculation and in some cases has been very wide of the mark (one newspaper misunderstood the issue so much it had a headline talking about 'donor eggs', though this issue is not specifically to do with do women having donor egg treatment)

The HFEA's key aim is to come up with a workable solution to the problem of multiple births that does not prejudice the treatment of individual women.

Once the views of patients, clinic professionals and other interested parties are taken into account, the Authority will then consider what action - if any - should be taken. No decisions will be taken before October 2007 at the very earliest.

More information can be found here : http://www.hfea.gov.uk/en/483.html 

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HFEA Statement on Donating Eggs for research – February 2007

Angela McNab, Chief Executive of the HFEA, said:

“Today (20 February 2007) the Authority agreed to allow women to be able to donate their eggs to research projects, provided that there are strong safeguards in place to ensure the women are properly informed of the risks of the procedure and are properly protected from coercion.

“In the UK we already have strong safeguards for egg donation for treatment which take into account its risks and benefits, the legal status of donors and welfare of any children born as a result of donation.

“Having considered all the information on donating eggs for research, including the risks to women and the outcomes of the public consultation, the Authority has decided that women will be allowed to donate their eggs to research, both as an altruistic donor or in conjunction with their own IVF treatment. Given that the medical risks for donating for research are no higher than for treatment, we have concluded that it is not for us to remove a woman’s choice of how her donated eggs should be used.

“In allowing this, the Authority insisted that donation for research would be allowed under the same rules as donation for treatment but with clear safeguards in the process.

“These safeguards include having clear separation between the researchers and people carrying out the woman’s treatment, detailed information about the realistic outcomes of the research and the impact the donation would have and requiring the person getting the woman’s consent being independent from the research team.

“These safeguards should prevent women from being coerced or misled into donating their eggs or from being misinformed about the extent to which their donation might impact on research.”

“Women will not be paid for donating their eggs. Researchers will have to follow the same system as donation for treatment; donors can only claim back the expenses that they have actually incurred. There has never been any question of women receiving payment for donating their eggs for research at any stage of our deliberations

“The Authority’s policy will mean women who donate eggs for research will get strong protection in a very closely regulated sector.

“People donating for research will not be able to do so without considering the matter seriously. Researchers will be obliged to wait after a woman has agreed to donate to allow her time to reconsider her decision. This will be a carefully paced process where women will receive proper counselling about the risks and implications of their decisions to donate.

“We don’t expect to see a rush of applications as this is a very specialist area of research, carried out by a limited number of centres. However, it has raised important ethical issues, which is why we needed to do a full and broad consultation in this area.”

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