Women under 37 will be unable to try for twins at first IVF treatment
NICE states that only one embryo should be replaced to reduce the risk of complications
Jeremy Laurance is a writer on health issues. He is former health editor of The Independent and the i and has covered the specialism for more than 20 years. He thinks the harm medicine does is under-appreciated, the harm it prevents over-rated, and that cycling works better than most drugs. He was named Specialist Journalist of the Year in the 2011 British Press Awards.
Wednesday 20 February 2013
Women under 37 having IVF will not be permitted to try for twins at their first attempt, under official guidance published today.
Only one embryo should be replaced to reduce the risk of complications associated with a multiple birth, the National Institute for Clinical Excellence (NICE) has said.
The ruling angered campaigners who said it flew in the face of Government directives on patient choice. But medical experts welcomed the move saying it would bring "major benefits" to mother and child.
The guidelines, updated for the first time since they were published in 2004, also recommend the upper age limit for IVF be extended from 39 to 42, reflecting advances in treatment.
However, women in this age group will be restricted to one cycle of IVF, compared with the three recommended for younger women, on grounds of cost effectiveness. Success rates decline rapidly in women over 40.
Same-sex couples are included in the guidelines for the first time. They say those hoping to start a family should be treated according to the same criteria as heterosexual couples. Also, IVF should be considered for couples after two years trying for a baby, rather than the current three.
The new guidance comes at a time when the NHS is under growing financial pressure as it seeks £20bn of savings by 2015. Many trusts do not follow the existing guidelines, such as providing three cycles of treatment to eligible women, on grounds of cost. One cycle costs the NHS about £3,000.
Clare Lewis-Jones, chair of the National Infertility Awareness Campaign, welcomed the extension of the eligibility criteria for IVF. But she warned: "It is pointless if the recommendations are not put into practice."
Keith Reed, chief executive of the Twins and Multiple Births Association, said: "This is a sad day for patient choice. Previously a desperate family may have made an informed decision to have twins to complete their family but these guidelines remove this option."
The Human Fertilisation and Embryology Authority (HFEA) said multiple births "remain the biggest single preventable health risk to mothers and babies following IVF." It increases the risk of stillbirth, infant death and disability in babies, and miscarriage, high blood-pressure and pre-eclampsia in the mother.
The HFEA has ordered clinics to reduce the multiple birth rate to less than 10 per cent of all IVF births from the current 20 per cent (in the general population it is less than 2 per cent).
Dr Tony Falconer, president of the Royal College of Obstetricians and Gynaecologists, said: "We know that replacing more than one embryo in the uterus can result in a multiple pregnancy, which carries a higher risk of complications, therefore a reduction in multiple births would have major benefits."
A spokesperson for NICE said the one embryo limit applied only to the first attempt at IVF for women under 37. Two embryos were permitted at subsequent attempts.
Case study: 'We had no hesitation opting for two embryos'
Kirsty Broadbent and her husband Philip had been trying for a baby for five years by the time they started IVF treatment on the NHS at St Mary's Hospital Manchester in 2008.
She was 29 and after having all the tests, which failed to reveal a cause for the couple's infertility, they were asked if they wanted one embryo or two, the maximum allowed at that time.
"We had no hesitation. We had been trying for so long and to us it increased our chances. We opted for two." She got pregnant at the first attempt.
"Matthew and Isobel were born within two minutes of each other. They were perfectly healthy and have stayed healthy since."
Board creates magnetic field to achieve lift
Singer says the track was 'force-fed down people's throats'
Trend which requires crisps, a fork and a strong stomach is sweeping Mexico's streets
George Lucas criticises the major Hollywood film studios
Film follows park rangers in the Congo
Does Chris Grayling realise what a vague concept he is dealing with?
- 1 Jack the Ripper: Scientist who claims to have identified notorious killer has 'made serious DNA error'
- 2 Banksy arrest hoax: Internet duped by fake report claiming street artist's identity has been revealed
- 3 Drink alcohol and eat meat to improve male fertility - but cut down on coffee, studies suggest
- 4 Former East 17 frontman Brian Harvey turns up at Downing Street and 'demands to speak to Prime Minister'
- 5 The inventor of the Facebook 'like' button says he never made a 'dislike' button because he feared the 'unfortunate consequences'
Ukraine crisis: Donetsk 'tactical missile' explosion at factory sends blast wave across rebel-held city
Jack the Ripper: Scientist who claims to have identified notorious killer has 'made serious DNA error'
Banksy arrest hoax: Internet duped by fake report claiming street artist's identity has been revealed
Super-sized ships arrive in Britain: How big can they get?
Former East 17 frontman Brian Harvey turns up at Downing Street and 'demands to speak to Prime Minister'
Cameron is warned 'no possibility' of UK reducing immigration and that bid to bring in quota on migrant workers would be illegal
Residents should throw a street party and mix with immigrant neighbours, councils told
Russell Brand threatened with arrest after filming outside Fox News headquarters
Amal Alamuddin calls for the return of the Elgin Marbles from Britain: 'Injustice has persisted for too long'
London bus driver 'kicks gay couple off for kissing'
Lord Freud: Tory welfare minister apologises after saying disabled people are 'not worth’ the minimum wage
£120 - £140 per day: Randstad Education Group: English as an Additional Langua...
£10000 - £15000 per annum: Randstad Education Cambridge: Nursery assistants re...
£60 - £65 per day: Randstad Education Liverpool: Job opportunities for Seconda...
£120 - £140 per day: Randstad Education Liverpool: Job opportunities for Secon...