UK fertility safety for women is 'among the worst in Europe'

Mothers' health may be put at risk in the quest for high pregnancy rates at British IVF clinics, warn experts

Adele Waters
Sunday 06 April 2008 00:00

The UK has one of the worst fertility treatment safety records in Europe, according to new figures published by the European Society for Human Reproduction and Embryology.

The chances of developing serious complications are up to four times higher in the UK than in other countries carrying out similar numbers of fertility treatments. Experts warn that women's lives are being jeopardised in order to improve the numbers of successful pregnancies

Britain has the highest levels of ovarian hyperstimulation syndrome (OHSS), the most serious and potentially fatal side-effect of IVF treatment, the figures show. At least two women with OHSS have died in the past three years, and there are fears of more cases going unrecorded.

Complications from IVF treatment from the use of drugs to stimulate the production of eggs can range from severe bloating and vomiting, to kidney failure, and even death in rare cases. Fertility experts say they fear many serious cases are not being recorded, because women go straight to casualty or end up in intensive care, the cause of their symptoms going unnoticed by the Human Fertilisation and Embryology Authority (HFEA).

Germany carried out in 2003 almost three times as many IVF cycles – implantations of fertilised embryos – as the UK, researchers found, but the UK had nearly three times more cases of OHSS. In 2004, France carried out nearly twice as many IVF cycles as Britain, but its OHSS rate was a quarter of that in UK clinics.

The figures have been compiled on the eve of a major international fertility conference, which opens in London on Thursday. It will debate how fertility treatments should be made safer, which would include the use of less intensive drug treatments.

Many European doctors believe the figures reflect the UK's emphasis on results – successful conceptions – over patient safety. They say the UK achieves average to above average pregnancy rates, but lags behind Europe when it comes to safety of women undergoing treatments.

Dr Karl Nygren, chairman of the International Committee on the Monitoring of Assisted Reproductive Technology, which monitors IVF treatments worldwide, said: "When it comes to measuring success of fertility treatments there are two measures: efficacy and safety.

"In the UK, you are good on efficacy – your success rates are in the top 10 countries – but your safety record is low."

Referring to the birth of the first IVF baby Louise Brown in Britain in 1978, he said: "You should be better – you are the ones who started it all off! In the UK, procedures are not being handled as optimally as they should be."

Dr Geeta Nargund, president of the International Society for Mild Approaches in Assisted Reproduction, said: "These OHSS figures raise alarm. In the UK, we are moving towards safer fertility treatment. Natural and mild IVF are aimed at preventing and reducing serious complications like OHSS.

"We have a duty to safeguard the health and safety of women undergoing fertility treatment. The HFEA takes into account the 'welfare of the child', but it should also implement strict clinical guidelines to ensure the 'welfare of the woman'. In my view, clinical information regarding risks and complications for each clinic should be publicly available."

The HFEA said: "Women considering IVF should have a full and frank discussion with their clinician about the risks involved and about what other treatment approaches might be suitable, such as newer techniques like in vitro maturation (IVM) or soft IVF (using fewer drugs)."

Overall scrutiny was difficult, it said, as there is no central reporting system. An HFEA commissioned report found severe OHSS occurs in about 1 per cent of treatment cycles in the UK.

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