Britain's policy to restrict the number of embryos women can receive during fertility treatment fails the least fertile women and pushes down clinics' success rates, according to one of the world's leading fertility specialists.
The UK's fertility watchdog, the Human Fertilisation and Embryology Authority, introduced limits on fertility clinics last year restricting the number of embryos they can implant in each cycle of treatment. Women under 40 can have only two embryos transferred in each cycle, while older women can have up to three implanted. The limits were brought in to reduce the risk of twin or triplet births.
David Adamson, vice president of the American Society for Reproductive Medicine, said limiting the number of embryos women can receive in treatment meant some patients, often older or less fertile women, risked getting too few, damaging their chances of conceiving. "[The policy] results in fewer multiple births but also results in some women with a poorer prognosis receiving fewer embryos than would be appropriate to optimise her chances for pregnancy." In July, the HFEA announced a review to consider whether the restrictions should be tightened, allowing only one embryo to be implanted in each cycle. Dr Adamson said fertility treatment would lead to more successful pregnancies if extra embryos were transferred to those patients who were likely to have most trouble conceiving, with fewer given to those expected to fare better. "I don't think arbitrary government regulation is the right approach, but then neither is unbridled individual freedom for patients and physicians either."
His comments followed the publication of the world's largest league table of fertility clinic results from the international committee for monitoring assisted reproduction technology. The results, compiled from 1,429 clinics in 49 countries for 2000, showed that British fertility clinics averaged a live birth rate of 19.4%, higher than the European average of 16.4% and the world average of 18.6%. Britain's figures compared well with Germany, which had a live birth rate of 14.8% but fell short of Denmark at 21.9%.
A HFEA spokesman said: "Having multiple births is the single biggest risk of IVF, to mothers and the children born ... we have reduced this risk dramatically."
