13 May 2011
New figures released today show that multiple births from IVF continue to fall. This follows the HFEA’s initiative to reduce multiple births – the single biggest risk of fertility treatment, and is supported by leading professional bodies in the sector.
It is well established that multiple births is the single biggest risk to mothers and babies associated with fertility treatment. To address this problem, the HFEA introduced a policy in 2007 to promote single embryo transfer by instructing each UK clinic to have a strategy to reduce their incidence of multiple births, in line with a target set by the HFEA.
The first HFEA multiple birth rate target was introduced in 2009/10 and was set at 24%. This was reduced to 20% in 2010/11. In April of this year a new target of 15% was set for clinics to meet by April 2012. Since January 2009, the proportion of single embryo transfers has increased and the multiple pregnancy rate has fallen.
Single embryo transfer (eSET) is most appropriate for women most likely to get pregnant, and therefore at most risk of a multiple pregnancy – those aged under 37yrs old with several good embryos available.
Since January 2008 (when we first started collecting data on eSET) the proportion of elective single embryo transfer has increased across the sector. In 2008, just 4.8% of embryo transfers were single embryo transfer. In the first half of 2010, this increased to 14.7%.
The most up to date results are for pregnancies and these show that in the same period the number of multiple pregnancies fell from 26.7% to 22.0% with the overall pregnancy rate maintained at 31.3%.
Between 2008 and mid 2009, multiple births fell from 23.6% of all IVF births to 22.0%
The latest figures show that the biggest fall in multiple pregnancies is in women under 35 years old. In this group, eSET has increased from only 6.6% in 2008 to 22.1% by June 2010 and multiple pregnancies have fallen from 31.2% to 23.9%.
The policy is part of a wider national strategy to reduce the number of multiple births resulting from fertility treatment, involving representatives from professional bodies, patient groups and NHS-funding bodies. The ‘One at a Time’ website provides clinics with the tools to change their clinical practice, information to patients and aims to share best practice across the sector.
Prof Lisa Jardine, Chair of the HFEA said: ‘It is excellent news that the number of multiple births is coming down whilst overall success rates for patients are still being maintained. This shows that the policy is proving successful. We have set a challenging target for the year ahead and will work closely with the sector to help clinics to meet the target, and at the same time retain patients’ confidence that their chance of success will not be significantly reduced.’
Jane Denton, Director of the Multiple Births Foundation said: ‘There is no doubt that a multiple pregnancy creates risks for both mother and babies. The good news is that the strategy is working and a great strength is the collaboration and partnership between the regulator, the clinics and the patients and professional organisations.’
Notes to editors
The national strategy is supported by: Association of Clinical Embryologists, British Fertility Society, Bliss, British Infertility Counselling Association, Donor Conception Network, Endometriosis UK, Human Fertilisation and Embryology Authority, Fertility Friends, Infertility Network UK, Miscarriage Association, Multiple Births Foundation, National Gamete Donation Trust, National Perinatal Epidemiology Unit, Royal College of Nursing, Royal College of Obstetricians and Gynaecologists, and Surrogacy UK. The national strategy is supported by: Association of Clinical Embryologists, British Fertility Society, Bliss, British Infertility Counselling Association, Donor Conception Network, Endometriosis UK, Human Fertilisation and Embryology Authority, Fertility Friends, Infertility Network UK, Miscarriage Association, Multiple Births Foundation, National Gamete Donation Trust, National Perinatal Epidemiology Unit, Royal College of Nursing, Royal College of Obstetricians and Gynaecologists, and Surrogacy UK.
A recent study in Canada published in the Journal of Pediatrics showed that nearly one in five babies admitted to the neonatal intensive care unit at Montreal’s Royal Victoria Hospital over a two year period were multiple births resulting from artificial reproduction. According to their calculations, a mandatory policy of single embryo transfer would lead to 840 fewer babies admitted to intensive care and up to 42,488 fewer days of intensive care. http://download.journals.elsevierhealth.com/pdfs/journals/0022-3476/PIIS0022347611001806.pdf