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In Vitro Fertilisation

Volume 488: debated on Wednesday 25 February 2009

To ask the Secretary of State for Health (1) what assessment he has made of the effect of a policy of single embryo transfer on the full implementation of National Institute for Health and Clinical Excellence guidelines on fertility by primary care trusts; (257359)

(2) what recent assessment his Department has made of how a policy of single embryo transfer will be implemented in fertility clinics; and if he will make a statement;

(3) what recent discussions (a) he and (b) his Department have had with (i) primary care trusts and (ii) other organisations on implementing a policy of single embryo transfer.

The Human Fertilisation and Embryology Authority (HFEA) in partnership with professional bodies and other stakeholders, including patient groups and representatives of the national health service (NHS), has developed a national strategy to significantly reduce the incidence of multiple births resulting from in vitro fertilisation (IVF) and related treatments. This strategy is known as the One at a Time campaign and includes promoting greater use of single embryo transfers (SET) where this is clinically appropriate for individual patients, leaving scope for the exercise of clinical discretion. The Department has observer status on the group that has determined the strategy.

The HFEA policy aims to lower the average national multiple birth rate from the current rate of just under 23 per cent. of all live birth events following IVF and related treatments to 10 per cent. For 2009, HFEA licensed treatment centres are expected not to exceed the 24 per cent. figure, a figure determined by the HFEA, on the basis of national average at the time the Year 1 target was agreed. This target will be progressively lowered towards a 10 per cent. national target. The HFEA will carefully monitor the impact of its policy, including any impact on fresh embryo treatment cycle pregnancy rates, to ensure that all the target rates set are appropriate. The HFEA will set a Year 2 maximum multiple birth rate in the light of progress during 2009. The HFEA wrote to all directors of public health in primary care trusts about this on 4 February 2009.

The HFEA has required all licensed treatment centres to have in place a documented multiple births minimisation strategy, setting out how they intend to reduce their annual multiple birth rates and to ensure that they do not exceed the maximum rate set. These strategies must include criteria for SET. Centres are required to send copies of their strategies to the HFEA.

The Department has established an expert group on commissioning NHS infertility provision to identify the barriers to the implementation of the National Institute for Health and Clinical Excellence (NICE) fertility guideline in England and to help NHS commissioners to progress towards full implementation of the guideline. The expert group produced an interim report in August 2008, which recognised that patients are more likely to accept SET if they are assured that provision of services is established in line with the NICE guideline.