The practice of transferring two embryos into the woman's womb during IVF is standard in the UK, in order to increase the chances of a woman having at least one successful pregnancy. However, it is well known that because of this, the instance of multiple births has massively increased in the UK.
Because a pregnancy with more than one baby has many more possible complications, the Human Fertility and Embryology Authority is reviewing standard practice.
The HFEA now want to see if a better process, where not all IVF treatments use two embryos, might enchance the pregnancy outcomes for more couples, rather than having one blanket treatment for everyone.
Why are IVF couples more like to have twins?
In couples who conceive naturally, the chances of having twins (or more), is about one in every 80 deliveries. However, because two embryos are implanted during IVF treatment, a couple having an assisted conception have a one in four chance of having twins. Interestingly, this is a lower figure than the nearly one in three, in 1991.
Two embryos are usually transferred during IVF, in order to raise the chances of conception, and, given the time, physical demands and financial cost of IVF treatment, this maximisation of the process has been routinely accepted for some time.
What's the problem with having twins?
If you have suffered the personal agonies of trying for a baby and are now seeking help, you are no doubt more than happy to risk having more than one child at a time.
However, whilst the majority of multiple births (usually twins) produce healthy babies, there are health concerns that go with any such pregnancy, which single pregnancies do not have.
A multiple birth, is itself what the HFEA consider to be the biggest health risk from IVF treatment, for the mother and babies.
For example, there is a greater risk of the babies being premature or of a low birth weight, two things which carry their own health problems at birth and into early life.
The risk of the infant dying before birth or in the first week of life is four times greater for twins than for single babies, and seven times greater for triplets.
Twins are five times more likely to have cerebral palsy than single babies, and triplets are 18 times more like to develop cerebral palsy.
The majority, as we say, do not have any problems, but it is an acknowledged risk.
Lifestyle adjustments as a family - increased costs, childcare etc - also need to be made, though, due to the increasing twin population, there is a much larger market of children's products in this field now, so prices have come down a little.
What now?
Standard policy remains unchanged: the transfer of two embryos per IVF treatment, in women under 40 years old. However, now that the year-long review of practice has been done, a public consultation will take place during 2007 and policy may be amended in autumn 2007.
The initial response seems to be that the Authority feel women should be evaluated on an individual basis, to see how successful using just one embryo might be, before transferring two as standard. However, the HFEA are keen not to compromise any woman's chance of IVF treatment being successful, so the final decision will only be taken after further expert, and public consultation.
For more about this and about everything to do with IVF and other fertility treatments, visit the HFEA website. It's written in a clear and very accessible way and has lots of useful and positive information.
