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IVF cuts 'putting lives at risk', warn fertility organisations

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The lives of mothers and babies are being put in danger by cutbacks to NHS fertility treatment, experts have warned.

They said that, with the current rationing, women were “taking a risk” and choosing to have multiple embryos implanted per cycle in the hope it will increase their chances of getting pregnant.

“There remains a drive for patients to consider ‘taking a risk’ when they are self-funding IVF”

Jane Stewart

However, this practice can lead to a multiple pregnancy, which increases the threat of serious health complications to both the mother and babies.

As a result, NHS commissioners are being urged to fund the three full IVF cycles recommended by the National Institute for Health and Care Excellence (NICE) to “incentivise” women to opt for a safer single embryo transplant.

The call has been made by a high powered grouping comprised of the Royal College of Obstetricians and Gynaecologists’ National Guidance Alliance in partnership with Multiple Births Foundation, the British Fertility Society, the Human Fertilisation and Embryology Authority, and the Fertility Network UK.

Research by the group found women who have a multiple pregnancy are more likely to suffer miscarriage, pregnancy induced hypertension, pre-eclampsia, gestational diabetes and caesarean section – with their risk of maternal death 2.5 times higher than those having one child.

The study also found one in 12 multiple pregnancies end in death or disability for one or more of the babies.

“The aim of IVF treatment should be the birth of a single healthy child”

Sally Cheshire

The group of organisations revealed that a multiple pregnancy costs the NHS almost three times more than a singleton at £13,959.

In a joint statement: they said: “Clinical commissioning groups should ensure that the practice of elective single embryo transfer is a key factor in the commissioning all NHS funded IVF cycles and should be promoted as the gold standard in all their policies chiefly to ensure the best and safest outcomes for mother and babies.”

Dr Jane Stewart, chair of the British Fertility Society, said: “There remains a drive for patients to consider ‘taking a risk’ when they are self-funding complex treatment to complete their much wanted family.

“Clear guidance on the ‘cost’ of that risk to them emotionally and physically is important but how much easier would that discussion be if treatment was equitably and appropriately funded so that the one-at-a-time advice did not carry that financial dilemma,” she said.

She added: “With millions already saved is it not time to invest into the future of excellent fertility care by providing properly funded safe treatment in the UK for all those that need it?”

National Confidential Enquiry into Patient Outcome and Death (NCEPOD)

Hospitals failing on nurse ratios for non-invasive ventilation

Lesley Regan

Professor Lesley Regan, president of the Royal College of Obstetricians and Gynaecologists, said offering three full cycles of NHS-funded IVF would “provide a greater incentive for IVF centres and their patients to adopt single embryo transfer more regularly”.

She added that developments in IVF technology had improved the live birth rate of single embryo transfer.

Sally Cheshire, chair of the Human Fertilisation and Embryology Authority, said: “This report is intended to inform commissioning decisions and reinforce the progress already made, so that the risks to patients and costs to the NHS, and society as a whole, are minimised.

“For all these reasons the aim of IVF treatment should be the birth of a single healthy child,” she added.

Aileen Feeney, chief executive of Fertility Network UK, said in England that 88.5% of clinical commissioning groups did not offer three full IVF cycles and 19 were currently consulting on slicing their service in some way.

In Wales, women are entitled to two full IVF cycles and in Northern Ireland the offer is just one partial cycle, Ms Feeney noted, adding that Scotland offered the recommended three full cycles.

“It is important to raise awareness among nurses and midwives of the social-political challenges in provision of fertility services”

Carmel Bagness

The Royal College of Nursing has also backed the demands made by the group of fertility organisations.

Carmel Bagness, the college’s professional lead for midwifery and women’s health, said: “The RCN supports the full implementation of the NICE guideline on fertility which includes three full cycles of IVF as this with elective single embryo transfer is an important factor in reducing multiple birth rates from IVF.”

She added: “It is important to raise awareness among nurses and midwives of the social-political challenges in provision of fertility services across the UK.

“Mothers with a multiple pregnancy and their babies require specialist care and commissioners of fertility services must ensure staff are appropriately trained to deliver this,” said Ms Bagness.

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