No more sanctions for clinics that don’t reduce multiple pregnancy rates

images-21So, the HFEA has decided to remove the sanction put in place to ensure clinics reduce their multiple birth rate following a legal challenge from two clinics.

Up until now, the authority had been able to put a condition on the licenses of clinics which didn’t keep their multiple birth rate below the set target – but this is now to be removed.

The Independent says that limits on the number of twins and triplets have been lifted, “following warnings from fertility experts that they harmed some women’s chances of becoming pregnant”.  In fact, the HFEA’s own statement on the issue explains that the decision was taken because it was not appropriate for the two IVF clinics which had taken the legal case to be treated differently from all the others – and removing the licence condition gives a level playing field.  Far from agreeing that limits on the number of multiple births should be lifted, what the Authority actually says is that clinics are still expected to get their multiple birth rate down to 10% in the interests of mothers and their babies.

Fortunately, most clinics appreciate the need to reduce multiple births and are working hard to ensure that those most at risk of a multiple pregnancy only have one embryo transferred.  The best fertility clinics are able to do this effectively without reducing their overall success rates because they are only too aware that multiple birth is the biggest health risk from IVF.  Prospective patients should always check the multiple birth rate of any clinic they are considering – and should be aware that a high success rate accompanied by a high multiple rate is a sign of a clinic that may not have your best interests at heart.

What do you want in a waiting room?

I’ve visited a lot of clinics in the last few months and am always interested in the different ideas they have about waiting rooms and what patients want.  Some are quite cold and clinical with stiff-backed chairs and nothing to look at, others are full of low sofas and potted plants, some offer magazines to read, others focus on fertility-related literature and some have a selection of fertility books.  Some have soft music playing, others have a TV on all the time in the corner.  It’s interesting to see how different the thoughts are about what patients want and what might be helpful.

One of my favourite waiting rooms is light and airy with an interesting view and lots of brightly coloured low sofas.  It has a machine for hot drinks and a selection of fertility books to read.  To me, it always feels instantly relaxing, but it benefits from being spacious and there’s a limit to what you can do when you have a very cramped space for the waiting room which a number of clinics do.  Of course, in the scheme of things waiting rooms are not important when it comes to choosing somewhere to go for your fertility treatment, but I think they do say something about how much thought and effort the clinic has put into trying to create a pleasant space for you – and that thought and effort may be reflected in other areas too.

The one thing which I think is really very difficult is a clinic waiting room which shares space with an antenatal unit as there is nothing worse than having to sit opposite a woman who is pregnant when you’re waiting for a fertility appointment.  Even sharing the same entrance and some facilities can be awkward.

I think my priorities would be comfortable seats, some books to look at and a space that made me feel secure and confident about confidentiality, but I’d be interested to know what you think… What makes a good fertility clinic waiting room? Are there things you’d really like that no one has thought of?



New fertility clinic for Norfolk

I was delighted to be asked to the opening of Norfolk’s first fertility clinic yesterday at Wymondham near Norwich.  The clinic is the latest outpost of Bourn Hall Cambridge – the UK’s first ever fertility clinic which was originally set up by IVF pioneers Robert Edwards and Patrick Steptoe.

It’s great that Norfolk finally has a fertility clinic; it had been one of those neglected areas of the country where having a fertility problem comes with the additional difficulty of needing to travel for treatment.  People don’t always give location sufficient consideration when choosing a clinic – a journey which seems fine when you do it once can sometimes become a complete nightmare when you’re doing it on a regular basis and can add to the stress of treatment.

You can read more about the new clinic from the local paper report here 

Patient perspective at the RCOG

I was delighted to be asked to talk at the Royal College of Obstetricians and Gynaecologists (RCOG) yesterday about the patient perspective on fertility treatment – it’s great that this is on the agenda at the College training days and that it is taken so seriously.  All too often when a patient perspective is considered, you’ll find it squeezed in at the end of the day on the last day of a meeting and half the audience will slope off to get the early train home, feeling confident that they aren’t going to miss any vital piece of new scientific opinion or advice – but the RCOG had put sessions on the patient perspective and counselling at the heart of their agenda yesterday.

Having spent many years talking to other people about their experiences of fertility treatment, I’ve come to realise that how clinicians deal with their patients is an essential element of their overall service.  Some scruffy down-at-heel clinics have received rave reviews from patients because of the care and attention that staff give to their patients, whilst other slick and seemingly professional places are less popular if they don’t seem to give any thought to how people feel about infertility.

I know that when you’re doing a job day in day out, it’s sometimes hard to appreciate quite what significance each word that you say has to your patients and how much is at stake for them with every stage of treatment.  Having said that, I’m endlessly amazed at the stories I hear from patients who are paying thousands of pounds for treatment at clinics where they never get to see the same clinician twice, where doctors spend the first five minutes of the appointment flicking through their notes to check who these patients are and where they’re up to and where they end up feeling like a nuisance if they want to ask questions or check information.

Infertility is tough at the best of times, but being treated sympathetically by people who take a few minutes to show that they are thinking about how you feel can make all the difference and I’m just so pleased that the RCOG recognises how important this is.


Clinic Open Evenings

More and more clinics are coming to see the benefits of opening their doors to prospective patients, and this is something that we should all welcome.  For anyone who is going to be spending their own money on fertility treatment, making sure that you feel you’ve chosen the right place for you is essential – and that’s why it’s a really good idea to go and see as many clinics as you can.  The more places you visit, the more you’ll get a feel for what matters to you and for what might suit you – and it’s easier to feel confident about your decision if you’ve visited some of the other options on offer.

I wasn’t sure about putting Open Evenings on my Events Page at first – free advertising for clinics and all that – but actually I’ve realised that they’re really useful for prospective patients.  So do take a look, and go along and visit some of the places near to you. Some even include a brief individual consultation as part of the Open Evening and this can be very useful.

Of course, for clinics the Open Evening can be a bit of a sales pitch – which some may push more than others – so the one important thing to keep in mind is that going to an Open Evening doesn’t in any way commit you to having treatment at a specific clinic.

Clinic open evenings

More and more fertility clinics are now holding open evenings for prospective patients which can be a really good opportunity to find out more about the options for treatment. Some even offer mini consultations with a fertility specialist to discuss your individual situation and what might be best for you.

It’s worth going along to as many of these as you can to get a feel for what would suit you.  Open evenings are a great source of information and will help you to understand the types of treatment on offer.  Remember that going to an open evening doesn’t mean you are committed to having treatment at any particular clinic.   Success rates and cost of treatment are important factors when you are choosing a fertility clinic, but atmosphere is important too – if you feel comfortable in an environment and like the staff, it is going to make treatment easier.