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  • 2008 HFEA Annual Conference
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About the session

‘The Future’ session covered scientific, social and ethical issues which will impact on the sector/HFEA over the short to medium term.

Results of the session

Future priorities for the HFEA – success rates

Participants felt that a key priority for the HFEA should be to focus on the practices/policies that will have the biggest impact for the biggest number of people, rather than focusing on issues that, while ethically/scientifically interesting, were not relevant to the majority of people receiving treatment in licensed centres.

The two issues that were identified by the group were:

• funding (particularly in light of potential political change), and
• how to improve success rates. It was noted that improvements in success rates would become a particularly relevant issue if public funding was cut and hence less cycles were available to some patients.

Participants also raised the problem of OHSS for patients undergoing fertility treatment and improving the efficiency of embryo culture.

Metabolomics / non-invasive embryo testing (analysing embryo culture media) was cited as a promising area.

Funding

• Participants discussed the possible implications for patients and the sector if there were cuts to NHS funding provision for fertility treatment.
• Concerns were expressed that this could lead to an increase in patients seeking fertility treatment abroad in search of cheaper treatment. It was also suggested that this could lead to an increase in patients participating in egg sharing programmes to benefit from discounted treatment.
• It was suggested that more effort should be made for the prevention of patients undergoing unnecessary IVF i.e. through educating patients about lifestyle choices.

Donor policies

• Participants discussed compensation for egg donors as part of the Sperm, Egg and Embryo Donation evaluation and the implication this may have on egg sharing programmes.
• Participants suggested that greater compensation may reduce the incidence of egg sharing; although this would not affect those egg sharers who had altruistic motivations for donating.
• Participants emphasised that more research was needed on the possible long term implications of egg donation for the egg donor and/or egg-sharer. However, the group noted that access to donors to conduct this kind of research was very difficult.
• The future role of the HFEA with regards to regulating the screening of donors was discussed. Participants noted that the HFEA currently prescribed several tests, but deferred broader screening requirements to professional guidelines. The possibility of, and associated problems with, screening for broad spectrum disorders was raised.

In vitro derived gametes

• Participants agreed that in vitro derived gametes was an area of promising technology.
• The group discussed the benefits of allowing people otherwise unable to produce their own gametes to have children of their own and how this would effectively solve the ‘problem’ of donation. However, it was emphasised that any human application of these gametes is banned by the HFE Act 1990 (as amended).

Embryo screening

• Participants discussed the future role of embryo screening and how screening may advance beyond testing embryos for a specific diagnosis i.e. ‘genetic MOT’s’.
• Participants also discussed the broader implications of discovering previously unsuspected genetic conditions in the parents.

HFEA Register

• Participants were enthusiastic about the potential for promising research once data became available from the HFEA Register.
• It was noted that Register data would provide a rich source of information to help understand the effect of fertility treatments and how to improve treatment.

Future role of the HFEA

• Participants discussed the future role of the HFEA as performing more of a role as an educator and information provider.
• In particular, the HFEA could play a useful role in educating people on issues, for example fertility prospects for older women, and the risks, success rates associated with egg freezing for ‘social’ reasons.
• Beyond this, there was a discussion about the importance of sharing best practice (connected with the immediate need to improve success rates) and the role of the HFEA in the co-ordination of sharing best practice.
• An issue was raised to challenge the success of sharing best practice, and this with respect to private clinics and the reluctance to lose a competitive edge.
• The HFEA does have a statutory duty to ensure that the sector carries out ‘suitable practices’ and we have a legal duty to safeguard patients.

Equality legislation

• The group discussed the possible implications the draft Equality Bill will have on the eligibility requirements set out in the NICE guidelines for the provision of funding for fertility treatment.
• It was noted that the provisions may be considered discriminatory under the new equality legislation.
  Globalisation of fertility treatment
• Participants discussed the increasing numbers of patients seeking fertility treatment abroad and the volume of information available to patients on the internet.
• Participants saw benefits in having a European consensus on fertility treatment to standardise treatment options for patients.

Social egg freezing

• The group emphasised the importance of the public being aware of the likelihood of success when storing eggs for social reasons.
• Participants emphasised that freezing eggs should not be viewed as an insurance policy for having children later in life.

Page last updated: 30 October 2009

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