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IVF multiple birth licensing condition for fertility clinics scrapped

But multiple birth policy remains intact, says regulator

Caroline White

Thursday, 14 November 2013

Fertility clinics offering IVF will no longer have to meet a target for multiple births set by the regulator, the Human Fertilisation and Embryology Authority (HFEA), as a condition of their licence, from January next year.

The HFEA has decided to withdraw this condition—one of the enforcement powers underpinning its multiple births policy—following a costly legal challenge launched by two UK clinics and a drop in the multiple birth rate associated with IVF.

The licensing condition had stipulated that the multiple birth rate for fertility clinics should be no higher than 10% of all IVF births.

The HFEA took the decision at its board meeting in London, earlier this week, following its failure last month to win a High Court battle against two clinics which argued that the decision on how many embryos to implant should be taken on medical grounds, not targets.

The HFEA insists that its multiple birth policy still stands. It intends to concentrate on other existing powers to enforce the policy, which has helped drive down multiple births from one in four IVF births to one in six, it emphasised.

In 2009, the HFEA launched its One at a Time campaign to inform patients and clinics about the risk associated with multiple births and the steps that could be taken to avoid them without significantly damaging success rates.

Since then, the overall multiple births rate has fallen from 24% to close to 15%. Clinics are now working towards a new target of 10%, a level which has already been achieved in several other countries, it says.

“We believe strongly in our multiple births policy – as do IVF professionals and patient groups, who have worked hard to reduce the avoidable risk of a multiple pregnancy over the past several years,” commented HFEA Chair, Lisa Jardine.

“The policy stands, and we will still expect clinics to bring the multiple birth rate down to 10% – in the interests of IVF mothers and their babies,” she insisted.

The decision to remove the licensing condition had come down to fairness, she said.

“It is simply not appropriate that two of the 83 IVF clinics should not have this particular condition on their licences. Professionals are entitled to a level playing field and, by removing this licence condition, that is what we will achieve,” she said.

“We believe that our time and resources are better spent continuing to work productively with the IVF sector on behalf of patients to bring the multiple birth rate down to acceptable levels,” she added.

An HFEA spokeswoman told OnMedica that the Authority would not have chosen this position, but said that the 10% target had been widely embraced by IVF professionals, and that she didn’t foresee any relaxation in attempts to meet it.

“We don’t expect the sector to step back from it,” she said. “The experience around it has been very positive.”

A joint statement issued by the Association of Clinical Embryologists, the British Fertility Society, The Multiple Births Foundation, and the Royal College of Obstetricians and Gynaecologists says that these bodies “believe that advances in IVF over the last decade have shown that elective single embryo transfer (eSET) can be achieved without adversely impacting on pregnancy rates.”

It continued: “[We] consider that eSET is now part of routine practice in the majority of clinics and that responsible professionals will continue to do all they can to minimise multiple births through good clinical practice.”

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