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IVF and Multiple Births

A new theory regarding the trend between IVF and twin births has been published by the Human Fertilisation and Embryology Authority.

According to the theory, the most common risk associated with IVF is a multiple pregnancy, which means twins or more. While some patients may desire twins, a multiple pregnancy can result in many complications for both the mother and children during pregnancy and afterwards. This includes premature delivery, low birth weight and on-going medical and developmental problems for the children.

The recent different birth ratio of single baby births and twin baby births confirm the theory.  About 11% of IVF assisted pregnancies result in two or more babies, compared to between 1% and 2% of naturally conceived pregnancies.

The organisation also shared its theory with HSJ and published it together along with National Guideline Alliance, part of RCOG. It said, “Multiple pregnancies are widely recognised as associated with IVF, because of the trend to transfer two or more embryos in the hope it increases the chances of pregnancy.”

On average, one-in-five IVF pregnancies are a multiple pregnancy compared to one-in-80 for women who conceive naturally.
Sally Cheshire, Chair of the HEFA, acknowledged poorer outcomes are an, “Unwitting consequence” of commissioners who are “limiting IVF to one or no cycle”.

She added, “These [IVF] decisions are about life and death. The commissioner [must] understand the cost of making those decisions about funding. This report is intended to inform commissioning decisions so that risks to patients and cost to NHS are minimised.”

She also stressed that there are funding problems and social struggles; the report also revealed the difference of cost on average between twin pregnancies and single pregnancies is around £10,000.

Since October 2017, 61% of clinical commissions groups in England offered one round of IVF, though a large number of them offer no IVF treatment. This happened because of the financial pressure.

According to Dr. Jane Stewart, chair of the B.F.S, self-funding patients cause a threat to themselves by choosing double embryos or seeking treatment in cheaper foreign IVF clinics rather than in the U.K.

Jane Denton, director of Multiple Births Foundation, said: “Good quality embryos are, you could almost say, being unethically wasted. We feel very strongly, full cycles should be offered to women on an equitable basis, rather than continue with the variation we see between CCGs.”

Aileen Feeney, chief executive of leading patient charity Fertility Network UK, said: “As NHS services are cut further you’ll see more people going abroad so chances are that the current rate of UK multiple births will go up from 10 percent.”

As per UK guidelines, wherever possible a single embryo should be transferred, but some clinics still transfer more than one embryo – sometimes because the patient wrongly thinks it improves their chances of having a child.

However, the research suggests that it is safer to transfer a single embryo.

NHS England didn’t comment on this matter. The Department of Health and Social Care pointed to the long-term deal which will increase funding by 3.4% per year but they didn’t disclose how much would be invested in IVF.

October 7, 2018

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