Britain's most prominent fertility expert has attacked the government's IVF watchdog for issuing its latest round of data on clinics as a league table.
"Unfortunately they don't compare like with like," Lord Winston said. "There's no way [patients] can assess how well a clinic is doing from those tables because some clinics go out of their way to treat difficult cases; others try to treat easy cases."
Launching the figures yesterday, the Human Fertilisation and Embryology Authority chairwoman Dame Suzi Leather said: "Patients do want to have the success rates for clinics and are happy with the idea of league tables to compare between clinics. However, patients are very canny about how they use this information and they know that these statistics are only part of the story."
She said patients could use a website to enter their details - such as age, location and treatment requirements - and receive a table tailored to their needs.
"This is a misunderstanding of how people would react," said Lord Winston, arguing it was inevitable patients would favour the clinics at the top. "I think it's ludicrous to publish a table of results and then apologise for doing so."
Clare Brown, chief executive of Infertility Network UK, which supports couples undergoing infertility treatment, said that even if the HFEA had not put the data in rank order, couples and the media were already doing so. She urged couples to look beyond a clinic's ranking. "Don't just necessarily go by the success rate," she said. "There are so many factors affecting each individual's chance of conceiving."
To illustrate the danger of using rank alone, Dame Suzi cited the example of Chelsea and Westminster hospital, which achieves a live birth rate of 31.1% for women aged 38 to 39 and for these women is ranked second in the country, but for women under 35 is ranked 55th.
The data, covering April 2003 to March 2004, show the average live birth rate per IVF cycle in the UK has increased from 20.4% to 21.6%, but actual rates vary among the 60 clinics from 10.7% to 53.8%.
Mohammed Taranissi, who runs the top ranked clinic, the Assisted Reproduction and Gynaecology Centre in London, denied he cherry-picked easy cases, saying that 80-90 % of his patients had failed at other IVF clinics. Publishing the data had driven improvements in standards, he said, because lower performing clinics had learned from those that achieve a higher live birth weight.
But Lord Winston said he was suspicious of the figures. "[There are] very serious questions about how some clinics are doing so much better when they are essentially using what is standard IVF."
One important factor is how many embryos a patient decides to have transferred with each IVF cycle. In most cases this is a choice between one or two. "There is a real risk in transferring multiple embryos and having multiple births," said Dame Suzi. More than one embryo increases the likelihood of a live birth but also results in more twins and triplets. Twins are four times as likely to die in the womb or within a week of birth, and five times more likely to have cerebral palsy. Triplets are at seven and 17 times greater risk respectively.
In a guidebook on fertility treatment also released yesterday, Dame Suzi said the HFEA had made warnings about the dangers of multiple births more prominent. "It is a risk warning," she said. "People should question whether it is really sensible to want a baby at any cost."
