Watchdog ponders curb on multiple embryo implants

The government's fertility watchdog may consider reducing the number of embryos implanted in women undergoing IVF to try to cut the high level of multiple births.

A consultation exercise on multiple births being launched tomorrow was welcomed by a leading fertility scientist, who said the Human Fertilisation and Embryology Authority had to act on the issue.

"The multiple birth issue is a problem," said Simon Fishel, director of the Care fertility group in Nottingham and one of the pioneers of IVF. "Any responsible practitioner would want to reduce any multiple pregnancy down to a single pregnancy because there are risks."

The HFEA is expected to outline possible restrictions on what kinds of IVF treatment should be available to infertile couples in order to maximise their chances of conceiving safely. Currently, women under 40 can have two embryos implanted while over-40s can have three.

"The reason you put more than one [embryo] in is because we know that 50% are not viable. If you've got four embryos, you know that only two are viable but, at this moment in time, you don't know which two to pick," said Dr Fishel. "One of the problems is that, however hard you try to eliminate multiple pregnancies, even with responsible practice, there will be a risk. For the regulator, they want to get on top of this and there's no easy solution except by reducing to a single embryo."

Multiple pregnancies can result in smaller babies who are born earlier than normal. Premature babies are at higher risk of dying and of heart and lung problems. They are also more likely to develop a range of problems from cerebral palsy to developmental difficulties.

There are also added stresses for the mother, such as dangerously high blood pressure and an increased risk of miscarriage, in being forced to deliver early.

An expert group report to the HFEA last year called for single embryo transfer to become the norm in IVF treatment to protect mothers and babies.

Dr Fishel said the HFEA should consider encouraging the implantation of single embryos wherever appropriate, particularly for women under 35, who have a higher chance of success with IVF. That could be backed up with regular assessments of individual clinics, with the aim of reducing multiple pregnancies to no more than 5% of the total.

He added: "The problem with that is that a large group of women will be compromised, there will be an awful lot of additional cost, both financial and emotional, and there will be a difficult line to tread to keep the pregnancy rate high while maintaining single embryo transfer."

Because implanting single embryos may reduce the chance of pregnancy for some women, the Twins and Multiple Birth Association yesterday called for NHS provision of IVF to be improved greatly to avoid a backlash from infertile couples, many of whom have to pay thousands of pounds for their own cycles.

One in 80 natural pregnancies results in a multiple birth, whereas one in four deliveries following fertility treatment involves more than one child. Up to half the 10,000 multiple births in Britain every year are the result of assisted conception.

An HFEA spokesperson said yesterday it had made no decisions on single embryo transfer and that results of the consultation would be released in autumn.