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October 20, 2006

Many IVF mothers might be better off with a single embryo transfer

U.K. fertility experts issued recommendations on Wednesday to reduce the rising number of twin births in cases of in-vitro fertilization, including the transfer of only one embryo into the womb.

In a report presented to the nation's fertility watchdog, the panel of experts said research has shown that limiting the number of embryos transferred can reduce the number of twins born through in-vitro fertilization without changing the overall success rate.

"Multiple birth is the single biggest risk to children born as a result of IVF," Professor Peter Braude of Kings College in London and the chair of the panel told a news conference.

Some patients and clinics opt for transferring two embryos to increase the odds of success, but Braude said the rate of twins can be reduced by limiting the number to one without damaging a woman's chance of conceiving. "The overall pregnancy rate is the same," he said.

The expert group identified two main options in the report. One would be to set a maximum twin birth rate of, for example, 5%–10% for fertility clinics.

The other is for single embryo transfer for women who are more likely to have twins. This would be determined by the woman's age, the quality of embryos produced, and other factors.

But Braude added that for some women, single embryo transfer may not be the best option.

The experts presented their findings to a meeting of the Human fertilization and Embryology Authority watchdog on Wednesday.

About 25% of IVF births in the United Kingdom are twins, They are more likely than single babies to be premature, which increases their odds of suffering medical and development problems.

The risk of death in the first week of life is five times higher for twins than a single baby. Twins are also around six times more likely to suffer from cerebral palsy and have a higher risk of congenital abnormalities, according to the report.

Multiple births also pose a danger for the mother. Twin births carry a higher risk of miscarriage, bleeding, early labor, caesarean delivery, and preeclampsia, a complication that occurs in about 5% of pregnancies.

Professor Bill Ledger, a fertility specialist at the University of Sheffield and a panel member, said the medical costs resulting from twins births are 16 times more than those for a single birth.

He estimated that reducing multiple births resulting from IVF could save enough money to fund 7,500 extra cycles of IVF, which could produce 2,000 children.

Professor Chris Barratt, of the University of Birmingham Medical School, said the United Kingdom should be aiming for a twin birth rate of about 5%. "One quarter of live births are currently twins. Even though this is perceived as a success, the truth is that it's much better for all concerned to have one child at a time," he said in a statement in reaction to the report. (Reuters)

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