August 2001

The Human Fertilisation and Embryology Authority today announced its decision to reduce the number of embryos that may be transferred in a single IVF treatment cycle from three to two.

This change in policy is intended to encourage best practice in clinics and so reduce the number of multiple births resulting from in vitro fertilisation.

Multiple births are associated with premature birth, low birth weight babies, a higher rate of stillbirth and neonatal death and long term disability such as cerebral palsy. In addition to the increased health risks to the babies, there is also increased risk for the mother including complications during pregnancy and stress and exhaustion due to coping with more than one baby.

Evidence shows that in the majority of cases the chances of a live birth where two embryos are replaced is almost identical to treatments where three embryos are replaced*.

Mrs Ruth Deech, HFEA Chairman, said:

“In most cases, replacing more than two embryos does not increase the chance of having a baby but can substantially increase the risk of a multiple birth. There is little benefit in replacing more than two embryos and there can often be considerable physical, emotional and financial costs.

We have been working closely with clinics for many years to reduce the number of multiple births and many centres are now transferring a maximum of two embryos in the majority of cases. This policy change is intended to further increase the number of one and two embryo transfers.”

In very few exceptional circumstances clinicians will be allowed to transfer three embryos in one treatment cycle. Details of such exceptions must be clearly documented for each patient and will be closely monitored through the HFEA inspection process.

The change in HFEA policy closely reflects guidelines produced by the Royal College of Obstetricians and Gynaecologists and the British Fertility Society.

Mr John Mills, Chairman of the British Fertility Society, said:

“This Society has recommended a move to the elective transfer of only two embryos and supports the decisions taken by the HFEA. We anticipate that the time will come when we will consider transferring only one embryo”.

Professor Allan Templeton from the Royal College of Obstetricians and Gynaecologists said:

“This RCOG strongly welcomes this recommendation and has been pressing for this for some time. There are still too many triplets births resulting from IVF treatment in the UK and the medical and social costs arising from premature birth and neonatal intensive care are considerable.

All the evidence indicates that reducing the number of embryos to two will in most women avoid the risk of triplets without affecting their chance of becoming pregnant. The aim of infertility treatment should be the delivery of a single healthy child and several clinics here and abroad are now looking seriously at replacing only one embryo per transfer.”

Note to editors

1. * Where more than four embryos were created (See figures 1 and 2 below)