British Fertility Society response to the HFEA calls for national strategy to reduce multiple births

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.”