'We feared another baby would die'

By Jane Elliott
BBC News, health reporter

Like many couples, Debby and Simon Cooper turned to fertility treatment in a bid to have their longed-for baby.

Debby now has a beautiful baby girl

But while many couples who opt for IVF want to have two, or even three, embryos implanted to increase their chances of expanding their family, the Coopers only wanted to have one embryo implanted.

They had already lost one baby, and did not want to risk the problems that can accompany a twin or triplet pregnancy.

Debby and Simon had conceived naturally in 2003. But at the 20 week scan, the sonographer spotted that a part of the little boy's brain had not developed properly.

They were told their baby had a rare condition called holoprosencephaly (HPE) - a disorder caused by the failure of the front part of the brain to develop properly, which also causes severe skull and facial defects.

HPE is very rare, affecting only 1 in 30,000 pregnancies.

Doctors said that there was a chance that it could happen again Debby Cooper

Debby and Simon were told their baby was unlikely to survive in the womb, and that even if he did he was unlikely to survive days or even hours after birth.

The couple decided to terminate the pregnancy at 21 weeks.

Debby says: "It was a hard decision to make, but it was not as if we were even facing a choice of whether to choose to have a severely disabled child. We were told that he would not survive.

"There was nothing to tell us why it had happened. It just seemed to be a mystery - a quirk of nature.

"But the doctors said that there was a chance that it could happen again and gave us odds of between 5-50%, although they did say it was probably just a fluke."

Fertility treatment

The couple tried to conceive again, but were unsuccessful and they felt they had to consider fertility treatment.

Debby, 30, said they were sure they only wanted one embryo implanted.

"I did not want to run the risk of having a pregnancy with one healthy and one not healthy."

BIRTH RISKS FOR TWINS Twins are three times more likely than single babies to be stillborn They are four times more likely to die after birth Twins are six times more likely to develop cerebral palsy Mothers of twins are more likely to suffer high blood pressure and face a higher risk of morbidity

She was also worried that if one baby was healthy but the other had a life-threatening condition such as HPE, terminating one foetus might risk the other.

"I was worried about going through IVF and ending up with another dead baby."

The method the couple chose, called single embryo transfer, is one of the suggestions being considered by the Human Fertilisation and Embryology Authority, who are considering ways of reducing the number of multiple births.

Presently, one in four IVF pregnancies results in twins - more than 10 times higher than the rate of twins born from natural conception.

'Patients should decide'

Debby and Simon paid around £4,500 for private fertility treatment, as they were worried about a lengthy NHS wait.

The first cycle of IVF was successful, and Debby gave birth to baby Amy in March this year - on the same date her brother was due.

But she said she did not think couples having fertility treatment should be limited to having one embryo implanted.

"Although it was right for us, it's a very emotive issue.

"For the majority of well-informed people who are paying patients, the choice should be left to be decided by the parents and consultant.

"A 'one size fits all' approach will not work, and will force many people to seek fertility treatment abroad where the regulations are not as strict."

Dr Kate Field is a senior researcher at Dipex - the Database of Individual Patient Experience - which has set up a special section on its website called 'Ending a Pregnancy', offering parents like Debby and Simon a chance to hear the experiences of others.

She said: "Finding out from a scan or a diagnostic test that your much-wanted baby has an abnormality is deeply shocking.

"Once they take the baby's diagnosis on board, parents are then faced with the kind of decision that no-one ever wants to have to make."

She said hearing about other people's experiences appeared to help people reach a conclusion about what they felt they should do.