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Leading article: IVF... women's health must come first


As society in Britain gets older, the age at which people marry and start families, or have children without partners, is also rising.

One consequence of this trend towards women having their first child on average in their late 20s or early 30s is growing difficulties in conceiving and the rapid growth in demand for assisted reproduction services, such as IVF. Over 45,000 women were treated with IVF in the UK in 2010 and the number goes up each year.

But as we report today, some experts fear that in a largely commercially driven industry, where the pressure for results in terms of pregnancy is enormous, the long-term safety of many women is being put at risk through the use of what appear to be unnecessarily high doses of drugs and risky interventions. According to Professor Geeta Nargund, high-dose stimulation can lead to a condition known as Ovarian Hyperstimulation Syndrome, OHSS, which at its most severe can cause kidney failure and death and is now one of the biggest cases of maternal mortality in England and Wales.

This is not the case in some other European countries, or in Canada, where milder, less toxic drugs are usually used to stimulate the ovaries, producing lower pregnancy rates but also safeguarding women's health and allowing them to recover faster and repeat the same treatment within a month if they wish.

Most IVF treatment in Britain is private – but this is not a simple case of evil private versus good state medicine. The demand for results and for the use of strong drugs often comes primarily from lobbies representing infertile couples, whose desperation to have children is heartbreaking and whose pressure on the industry to "deliver" – emotional pressure as much as anything else – is relentless.

Nevertheless, there is surely a warning for the rest of the health service here about what can happen when commercial principles are introduced into health, which is that safety concerns can start taking a back seat. At a time when there is much talk of introducing more competition into the health service, we need to be vigilant in ensuring that patient safety continues to trump any other considerations.