Andy Glew

IVF clinics told to cut multiple births to 10%

The HFEA have recently announced a new target for all UK centres to reduce their multiple births down to 10% for all treatments from 2012.

This is why 55% of our patients under the age of 40 years are having just one embryo replaced.

It is now well established that multiple births is the single biggest risk to mothers and babies associated with fertility treatment. To address this problem, the HFEA introduced a policy in 2007 to promote single embryo transfer by instructing each UK clinic to have a strategy to reduce their incidence of multiple births, in line with a target set by the HFEA.

The first HFEA multiple birth rate target was introduced in 2009/10 and was set at 24%, which was then reduced to 20% in 2010/11 and in April of last year a new target of15% for all clinics was set.   As a result, since January 2009, the proportion of single embryo transfers has increased and the multiple pregnancy rate has fallen.

Every IVF centre in the UK will have a single embryo transfer strategy which should be in place to reduce their multiple birth rate.  Each centre will have different strategies and some will be more strict than others, but ultimately the HFEA will not look favourably at a centre that fails to address the issue.

Scandinavian countries have always led the way in maintaining very low multiple birth rates and at the European Society of Reproduction and Embryology in Stockholm this year we heard about a new checklist that a Swedish clinic had devised to help predict the chances of pregnancy based on four factors – the age of the woman, how many eggs produced, quality of the embryo to be transferred and past success with IVF.

Using this checklist on patients going through IVF over a four-year period, they were able to reduce the number of multiple births from just over 26% to less than two per cent, whilst maintaining the live birth rate.
At the Herts & Essex Fertility Centre we are able to use our database comprising of more than 15 years worth of data from over 8000 patients to model various strategies to create a successful approach to reduce our own multiple pregnancies.  In addition, by calling us and giving us a few details we can also give you an individualised success rate based on your personal history and our past performance.

As a team we do support the new HFEA targets and we support the guidelines by continually reviewing our data to ensure that we maintain the expectations of our patients and provide safe pregnancies through to term.
Our strategy is simple.  If you are young and healthy and having a blastocyst transfer we will transfer a single embryo.  If you are older we will review the strategy and replace two.  If you are 40 yrs and older then of course the more embryos replaced the better your chances and so we may seriously consider replacing three.  Our strategy involves making decisions based on our experience and following a full discussion with you the patient.

What is important to realise is that our strategy has not affected our overall performance.  Currently 56% of our younger patients (less than 38 years) have achieved a pregnancy and 65% of these have had a single embryo replaced.

In recent communications from the HFEA it appears the UK has made an excellent effort in reducing the multiple births through fertility treatments and the current national multiple pregnancy rate is 19.9%, which is a reduction from the 2010 multiple live birth rate of 22.0%

For more information on moving towards single embryo transfer go to www.oneatatime.org.uk

For more information or to find out your individual treatment statistics call 01992 78 50 60 or email enquiries@hertsandessexfertility.com

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