I’ve had a couple of questions recently from people about success rates at fertility clinics, and it is clear that one thing that sometimes gets overlooked when you are considering the relative merits of different places is the multiple birth rate. In fact, it’s just as important to look at this as it is to look at the overall success.
In the UK, clinics are actively trying to reduce their multiple birth rates as they recognise that this is the biggest health risk from IVF – the idea of twins can sound marvellous, but a multiple pregnancy can bring serious risks for both mother and babies. The overall multiple rate after IVF has gone down in the UK from one in four babies to one in six, and yet success rates have remained stable. This shows that by selecting the right patients for single embryo transfer, you can maintain good success rates while at the same time reducing the risks. If you want to know more, the One at a Time website is the best place to start.
Some clinics overseas do still routinely put back three or more embryos – I came across a young couple a while ago who’d had five embryos transferred. This isn’t a sign of a good clinic trying to help you to get pregnant, but rather of a clinic which may not have your interests at heart. Even within the UK, multiple rates can vary hugely, so do check them out and remember that a really good clinic will have a good success rate combined with a low multiple rate.
Fertility patients will welcome a new study which has found that children born after assisted conception have been getting steadily healthier, with fewer babies born prematurely. It’s the largest study to look into the health of IVF babies, and followed 92,000 children born after assisted conception from Denmark, Finland, Norway and Sweden.
A key factor in the improved health of the children born after fertility treatment was the reduction in multiple births – this means that babies are less likely to be born prematurely which is a big risk associated with multiple pregnancy. Although this study focused on children born in Scandanavia, we have also seen a decline in the number of multiple births after IVF/ICSI in the UK and this research shows that the One at a Time policy we’ve adopted here will not only impact on multiple pregnancy rates, but also on the health of children born after assisted conception.
You can read more about the study, which is published in the Journal Human Reproduction, here http://humrep.oxfordjournals.org
It can be tempting to imagine that a multiple pregnancy might be the ideal outcome after fertility treatment – an instant family and no need to pay for any more IVF in the future. In fact, multiple pregnancy is the biggest health risk from fertility treatment, and the terribly sad story of the woman from Arizona who died shortly after giving birth to quadruplets shows just how risky it can be.
Here in the UK, the multiple pregnancy rate after fertility treatment is declining and clinics are encouraged to think carefully before transferring more than one embryo to younger women in particular. Women’s bodies are made to carry one baby at a time, and the biggest danger from a multiple pregnancy is that the babies will be born early – which carries all kinds of long-term health risks.
If you want to know more about the evidence on multiple pregnancy and fertility treatment, you should visit www.oneatatime.org.uk
Fertility Matters is back again now, and wanted to send congratulations to Professor Peter Braude who received an OBE in the New Year’s honors for services to reproductive medicine. Professor Braude is a very highly regarded expert in this field, and yet has always had time to listen to the patient perspective. He chaired the group set up to look at multiple births after IVF, which recognised that multiple birth is a huge health risk from fertility treatment and led to steps being taken to ensure that those who need IVF in order to conceive have the best chance of having a healthy baby.
Congratulations to Allan Pacey too – who has recently been appointed Professor. Professor Pacey is the former chair of the British Fertility Society and a sperm expert – you’ll probably have seen him on TV or quoted in the news whenever there’s a sperm-related story.
So congratulations to both Professors!
I’m delighted that the HFEA Chair Professor Lisa Jardine has taken to the online pages of BioNews to clarify that the decision to remove the possible sanctions for clinics which breach the multiple births target doesn’t mean a change of heart on the policy itself.
There appeared to be a complete misunderstanding of what was actually going on in much of the coverage at the time as it was widely reported that clinics would no longer be expected to continue to reduce multiple births – which isn’t the case at all. As Lisa Jardine explains, the reasoning behind the change came after two years of legal wranglings with just two fertility clinics who argued against the licence condition that no more than 10% of their births should be multiples. It was felt that it would be wrong to continue to spend large sums of money fighting the challenge in the courts, and that it was also unfair to all the other clinics that just two of them should be treated differently.
In fact, the One at a Time policy has been very successful, with an overall reduction in the multiple birth rate after fertility treatment down from 24% to 16%. Successful clinics are heading towards the 10% rate now set as a target by the HFEA.
It’s fertility patients who can help push things in the right direction, by asking clinics about their multiple rate or checking this on the HFEA website – and by continuing to remember that a clinic with a high multiple rate should set alarm bells ringing. A really good fertility clinic will have a good success rate and a low multiple pregnancy rate, while a clinic with a high multiple rate is not focused on the future health of patients and their children.
You can read what Professor Lisa Jardine had to say here