HFEA policy

The HFEA is committed to minimising the risk of multiple births and the requirement is for all clinics to reduce their multiple birth rate to a maximum of 10% of live births (or to a rate of 10% or less of live births).

What are centres required to do?

All IVF centres must have a multiple births minimisation strategy that sets out how the centre:

  • intends to achieve a reduction in its multiple birth rate to no more than 10% of live births;
  • identifies suitable cases for single embryo transfer, using defined patient selection and embryo assessment criteria in both fresh and frozen embryo transfers.

Centres are required to undertake regular audits in order to evaluate the effectiveness of their strategy and refine as appropriate. Data submitted to the HFEA will be used to monitor individual clinic performance and if multiple birth rates are persistently higher than the 10% target, the HFEA will consider recommendations for actions, in line with the Authority’s overarching Compliance and Enforcement Policy. They must also log cases in which multiple embryos were transferred in patients despite meeting their criteria for single embryo transfer.

Finally centres should read:

Progress so far

Data analysed in 2015 demonstrate there has been a marked shift from patients having a double embryo transfer (DET) to an eSET. This is most noticeable in younger patients in their first treatment cycle

  • As a result, the multiple pregnancy and multiple birth rates have dropped markedly. Overall, the multiple births rate dropped from one in four IVF live births in 2008 to only one in six in 2013.
  • Despite this dramatic change, pregnancy and birth rates have been maintained and have recently started to rise.
  • Women under 37 years of age in their first fresh treatment cycle have a higher pregnancy rate after eSET than after DET.

This remarkable achievement is the result of a collaborative approach, with patient groups, professional societies and the HFEA working together to change clinical practice. Clinics have developed their own strategies, in line with the HFEA policy, to identify the correct patients who benefit most from eSET. Crucially, they have reassured patients that eSET is the best – and most successful – treatment for them.

For more information on progress to date, read the HFEA’s report, Improving outcomes for fertility patients: multiple births 2015.

Further information

If you have further questions about the HFEA multiple births policy, please contact your inspector.