22-02-13 NICE Fertility guideline published

‘One at a time’ welcomes the revised Fertility guideline published by NICE on 20 February.

Since the 2004 Fertility guideline, there have been advancements in the management of infertility and our understanding of the risks associated with fertility treatment. This knowledge underpins the new guideline, translating into better clinical care for patients.

The recommendations on the number of embryos that should be transferred during treatment will help us to reduce the multiple birth rate following IVF to no more than 10%.

The guideline states that when considering the number of fresh or frozen embryos to transfer in IVF treatment: 

  • For women aged under 37 years: In the first full IVF cycle use single embryo transfer; in the second full IVF cycle use single embryo transfer if one or more top-quality embryos are available. Consider using two embryos if no top-quality embryos are available; in the third full IVF cycle transfer no more than two embryos.
  • For women aged 37-39 years: In the first and second full IVF cycles use single embryo transfer if there are one or more top-quality embryos. Consider double embryo transfer if there are no top-quality embryos; in the third full IVF cycle transfer no more than two embryos.
  • For women aged 40-42 years consider double embryo transfer.
  • Where a top-quality blastocyst is available, use single embryo transfer.

Fertility clinics will now need to consider how to incorporate these recommendations into their multiple births minimisation strategies, which the Human Fertilisation and Embryology Authority requires them to have in place, to enable them to make the best clinical decision for each patient.

Provision of fertility treatment on the NHS varies across the country. In England different Primary Care Trusts have differing levels of provision and different eligibility criteria. We hope that the new Clinical Commissioning Groups to be established in April will ensure that the guideline is fairly and appropriately implemented to allow patients to receive the full number of recommended cycles.

The Multiple Births Stakeholder Group will consider the possible impact of the revised guideline in due course.