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Health: Ovarian Hyperstimulation Syndrome

Volume 696: debated on Wednesday 5 December 2007

asked Her Majesty's Government:

Further to the Written Answers by Lord Darzi of Denham on 22 October (WA78-79), why the Human Fertilisation and Embryology Authority does not hold data on the numbers of in vitro fertilisation patients who have produced 20 or more eggs when this is considered to be associated with an increased incidence of hospitalisation due to ovarian hyperstimulation syndrome; and [HL77]

Further to the Written Answers by Lord Darzi of Denham on 22 October (WA 78-79), as the Human Fertilisation and Embryology Authority appears to have incomplete records regarding ovarian hyperstimulation syndrome such that this is not necessarily reported by clinics unless treatment was discontinued, whether treatment has always been discontinued whenever ovarian hyperstimulation syndrome was or is suspected; and [HL130]

Further to the Written Answers by Lord Darzi of Denham on 22 October (WA 78-79), whether they will describe the incidents in which adverse clinical effects associated with ovarian hyperstimulation syndrome have been recorded by the Human Fertilisation and Embryology Authority at each respective licensed centre since records began. [HL131]

The Human Fertilisation and Embryology Act 1990 requires a report to be made to the Human Fertilisation and Embryology Authority (HFEA) on every cycle of in vitro fertilisation (IVF) treatment carried out in the United Kingdom. This report includes information on the number of eggs retrieved from the patient.

While the HFEA has responsibility for the overall regulation of IVF treatment, decisions on whether to discontinue treatment in individual cases are matters of clinical judgment, taking account of professional guidance on the management of ovarian hyperstimulation syndrome (OHSS). In many cases it may be possible to continue with treatment after an adjustment to the patient's ovarian stimulation regime. Details of decisions made on patient care are recorded in local health records, which can be examined by HFEA inspectors when they visit the clinic.

The seventh edition of the HFEA's code of practice, which came into effect on 5 July 2007 to coincide with the introduction of the Human Fertilisation and Embryology (Quality and Safety) Regulations 2007 that implemented EU directive 2003/23/EC setting standards of safety and quality for human tissue intended for human application in respect of reproductive cells, requires any occurrence that is inconsistent with routine patient care to be reported to the authority. The HFEA expects an incident report from a licensed clinic whenever the clinic is made aware of a case of severe OHSS resulting in prolonged hospitalisation.

The HFEA recognises that licensed clinics might not always be made aware of developments in patient care after initial treatment, so the data submitted via the incident reporting system are not sufficiently comprehensive to allow statistical analysis of all OHSS cases.