Multiple births and single embryo transfer review

 

The Consultation

Best possible start consultation documentThe HFEA has launched a public consultation on the issue of multiple births after IVF.

Download the consultation document (465 Kb)

 

Currently, around 1 in 4 IVF pregnancies ends in the birth of twins. And although many twins are fine, a high proportion of twins are very vulnerable at the beginning of their lives, because they are born too early and too small.

The HFEA has been convinced by the argument made by the independent expert group report 'One child at a time' that being born as part of a set of multiples is the biggest known risk to IVF children's health and welfare.

The Expert Group also argued that this risk can be avoided if only one embryo is transferred to those IVF patients who have the highest chance of conceiving (and therefore the highest risk of conceiving twins).

The HFEA now wants to hear from anybody who is affected by these questions (for example users and providers of fertility, obstetric and neonatal services and parents of IVF children or twins in general).

The consultation aims to find a balanced way of making single embryo transfer for the best prognosis patients work in the UK, while - as far as possible - maintaining success rates and respecting patients' and clinicians' desire to make individual treatment choices.

 

How to respond

You can respond to our consultation three ways:

The best possible start
Human Fertilisation and Embryology Authority
21 Bloomsbury Street
London
WC1B 3HF

We need your response by 4 July 2007.

 

Public meetings

We will be holding public meetings where the issues raised by this consultation can be discussed. To request a place at the meeting or for more information, please contact us via bestpossiblestart@hfea.gov.uk or call 020 7291 8235. We will also be advertising these in the public events section of the website.
 

Press release and background statistics

Back to top

Background information on the project

Unlike natural conception-where the chance of having a multiple birth is relatively low (1 in every 80 deliveries is of twins) - assisted conception brings with it a high chance of a multiple birth (roughly 1 in 4 IVF deliveries is of twins).

Although most twins are well in the end, the chance of complications during pregnancy and delivery is much greater than with a singleton. The high incidence of multiple births following IVF is largely due to the fact that more than one embryo is usually transferred to the woman's womb during an IVF cycle. This is done to increase the chance of conception.

The aim of the project

The multiple births and single embryo transfer review aims to find ways of encouraging clinics to reduce their multiple birth rate without diminishing patients' chance of having a baby. This is most likely to be achieved by identifying those patients who are just as likely to conceive following the transfer of one embryo as they are with two.

Main stages of the review

This is a long-term project, during which the scientific and medical evidence-along with the views of patients, clinics and other relevant professionals-will be carefully considered. There are three main stages of the review:

  • October 2005-September 2006
    An Expert group reviews the evidence on multiple births and single embryo transfer and make recommendations to the HFEA
  • Early 2007
    The HFEA holds a public consultation, setting out options for reducing the incidence of multiple births following IVF
  • Autumn 2007
    The Authority makes a policy decision on the basis of the evidence and the consultation responses. It might then work towards new guidelines for clinics which would not come into force before 2008.

Back to top

The Expert group

The evidence gathering stage of the review was led by an Expert group, chaired by Professor Peter Braude of the Royal College of Obstetricians and Gynaecologists. The membership of the Expert group was broad-based and included representatives from clinical IVF, embryology, the patient perspective, data collection, multiple births, neonatology and NHS commissioning.

 

> More information about the Expert group and its members

> More information about the Expert group meetings

 

one child at a time reportThe Expert Group has completed and published its final report at the Authority meeting on 18 October 2006.

The report reviews the available evidence and discusses possible solutions to the problem of multiple births after IVF.

 One Child At A Time - Report of the Expert Group (482 Kb)

Executive summary (49 Kb)

 


Further information

If you have further questions about the multiple births and single embryo transfer review or would like to make a suggestion about an area of work, please contact:

Charlotte Augst
Policy Manager
Tel: 020 7291 8231
Email: bestpossiblestart@hfea.gov.uk

Back to top