Dear Colleague,

A multiple pregnancy is the single greatest health risk to both mother and child following IVF treatment. The risk of prematurity and low birth weight, for example, is minimised if a child is born as a singleton.

As part of its duty to take account of the welfare of the child born as a result of licensable treatment, and to ensure that Persons Responsible are undertaking suitable practice, the Authority has introduced a new policy that aims to reduce centres’ IVF multiple birth rates. The policy aims to lower the average national multiple birth rate from its current rate of 24% (of all live birth events following IVF/ ICSI) to 10% over a number of years. It does not replace the HFEA’s policy on 2 or 3 embryo transfer limits (see paragraphs G.8.5.1 to G.8.5.3 of the Code of Practice and D.2004/ 2 and CH (04) 01) but will run alongside it.

Multiple Births, Single Embryo Transfer policy

For the calendar year 2009, the HFEA-set maximum multiple birth rate for each clinic is 24%. In other words, all centres should ensure that their annual multiple birth rate does not exceed this figure.The HFEA is aware that many centres will already be on or below this rate. However, they will all be expected to work towards lowering their current rates with a view to the longer term 10% goal. Over the next few years, the HFEA will set progressively lower maximum rates and will carefully monitor the impact of its policy, including any impact on fresh cycle pregnancy rates, to ensure that all rates are appropriate.

By 1 January 2009, all licensed treatment centres will need to have in place a documented multiple births minimisation strategy (‘the strategy’) which will set out how they intend to reduce their annual multiple birth rates and to ensure that they do not exceed HFEA-set maximum figure. Guidance and requirements in relation to clinics’ strategies are outlined in the Code of Practice update (new paragraphs G.8.5.4 – G.8.5.5) and general directions (D.2008/05) attached with this letter. Centres are advised to begin developing their strategies in sufficient time to meet the 1 January 2009 start date.

If you have any queries about this letter, please contact the inspector for your centre.

Yours faithfully,
Professor Lisa Jardine

Page last updated: 17 August 2012