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Last Updated: Thursday, 1 June 2006, 08:11 GMT 09:11 UK
Single IVF embryo 'just as good'
Lab work
Many IVF cycles use more than one embryo
Selecting one quality embryo is as likely to result in a successful IVF pregnancy in older women as in their younger peers, research suggests.

The Finnish study suggests embryo selection is an option for some older women - rather than simply using more than one embryo in each IVF cycle.

Using more than one embryo raises the chances of a risky multiple pregnancy.

UK experts welcomed the Human Reproduction study, but said a culture change was needed.

We need to work hard to explain the risks of multiple births to patients and also to lobby for better state funding to allow couples the option for single embryo transfer without worrying about money
Dr Allan Pacey

Traditionally, the use of multiple embryos has been more common among older women, who are thought to have less chance of becoming pregnant during IVF.

Currently, woman under the age of 40 should be offered one free cycle of IVF treatment on the NHS in England under government recommendations, although the final decision rests with local primary care trusts.

Ministers have so far refused to fund three cycles for each woman, as recommended by the National Institute for Clinical Excellence.

At the University of Oulu clinic, where the latest study was carried out, four out of 10 women aged 36-39 are now treated with selected single embryo transfer.

As a result, the clinic's rate of multiple pregnancy has been cut to less than 10%. Multiple pregnancy increases the risk of premature birth, and other complications.

Similar rates

The researchers compared the results of more than 2,000 IVF cycles carried out in women in the older age group with those from younger women.

They found that, like younger women, a third of women aged 36-39 achieved pregnancy after a single IVF cycle using just one selected embryo.

The live birth rate was also similar: 26% for the older age group, compared to between 27% and 30% for younger women.

The chances of a pregnancy rose to 54% for women aged 36-39 who underwent more than one cycle of treatment using a single selected embryo each time.

The researchers also found that over several cycles of treatment single embryo transfer using selected embryos outperformed double embryo transfer.

While the pregnancy rate over time was nearly 55%, the rate of multiple births was less than 2%.

In contrast, the pregnancy rate among women who were treated with double embryo transfer was just 35%, while the rate of multiple births was 17%.

'Instant families'

A spokesman for the Human Fertilisation and Embryology Authority said it had set up an expert panel to find ways to cut the number of multiple births resulting from IVF treatment.

Dr Allan Pacey, Honorary Secretary of the British Fertility Society, said most UK professionals agreed using selected single embryo transfer as often as possible would have a huge impact in reducing the number of twins and triplets born as a result of IVF.

However, he said the success of single embryo transfer in countries such as Finland had only been possible because IVF is so well funded by the state.

"In the UK, where the majority of couples are paying for their own IVF treatment, twins and triplets are often still seen by couples as an "instant family" without the need for repeated cycles of treatment.

"We need to work hard to explain the risks of multiple births to patients and also to lobby for better state funding to allow couples the option for single embryo transfer without worrying about money."

Dr Pacey added that older women were less likely to produce high quality embryos, and that assessing quality was still not an exact science.

Clare Brown, of the Infertility Network UK, said: "It is understandable that the vast majority of couples are deeply unhappy about any move to single embryo transfer whilst there is still a severe lack of NHS funding for fertility treatment. "


SEE ALSO:
IVF 'should use one embryo'
29 Jun 04 |  Health
IVF multiple births 'drain NHS'
23 Jun 05 |  Health


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