Members of the National Strategy Stakeholder Group have produced a mission statement on reducing multiple pregnancies following fertility treatments, published in summer 2008.
The mission statement sets out the aims and principles behind the work of the National Strategy Stakeholder Group. It states that to minimise the health risks to both mother and child, "the aim of all fertility treatment should be the birth of a healthy, singleton child” and that this can be achieved by changes to clinical practice. These changes, however, require the active support and commitment of patients and clinicians.
To make these changes, the Group supports the development of the following aids to good practice:
The Group is also focussing on removing obstacles such as financial disincentives both within the private sector and within the NHS.
These aims can be achieved through the committed, consistent and collaborative efforts of the full range of parties involved, particularly those organisations who support and inform patients, nurses, embryologists and clinicians.
We are committed to making these changes occur through a number of means including:
The single greatest health risk for women conceiving following fertility treatment is a multiple pregnancy. On average, 1 in 4 IVF births is a multiple birth and other fertility treatments also present the risk of a multiple pregnancy. For example, the likelihood of a twin pregnancy resulting from clomifene treatment is approximately 10%.
By comparison, only 1 in 80 for women who conceive naturally have a multiple birth. Fertility treatment contributes significantly and disproportionately to the national multiple birth rate and therefore presents a significant public health concern.
The risk of an adverse health outcome for twin pregnancy is greater than for singletons. A significant number have a traumatic start to life, with approximately half of twins requiring hospitalisation and care in neonatal units.
Some children have serious, long term health problems or, in a tragic minority of cases, die. The risks for mothers are also greater, with some enduring dangerous complications during pregnancy some of which can cause ongoing health problems.
The risks of multiple pregnancy can be avoided or reduced through changes to clinical practice. This, in turn, will require the development of various tools and the removal of various obstacles. This programme of work requires the concerted and collaborative efforts of a range of parties including clinicians, embryologists; nurses; professional and regulatory bodies; patient organisations; the HFEA and NHS bodies.
This work can be termed a ‘National Strategy on minimising multiple pregnancy following fertility treatment’ and will be implemented through the combined efforts of a ‘Multiple Births’ stakeholder group and the commitment of all clinicians involved in the provision of fertility services.