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15 April 2011

One embryo limit for fertility treatment

If women undergoing fertility treatment were limited to one embryo transfer at a time, lives and money would be saved due to fewer complications from multiple births.

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If women undergoing fertility treatment were limited to one embryo transfer at a time, lives and money would be saved due to fewer complications from multiple births, Canadian doctors said.

"Across Canada, there would be as many as 840 fewer babies admitted to the NICU (neonatal intensive care unit), 40 deaths avoided, 46 fewer brain injuries, and 42,400 fewer days of NICU hospitalisation," said Keith Barrington, lead author of the study in the US Journal of Paediatrics.

Each day a baby spends in the NICU costs about $1,000 (about R68,000), meaning some $42.4 million (about R285 million)could be saved per year by restricting embryo transfers, according to the data compiled by doctors at the University of Montreal.

Women and couples who are having trouble getting pregnant often opt for in vitro fertilisation (IVF), which involves combining the egg and sperm outside the womb and then implanting the fertilised embryo in the woman's uterus.

Patients may opt for multiple embryo transfers in the hopes it will increase their chances of getting pregnant, and to cut back on the number of times the costly procedure is performed.

IVF and multiple births

But Montreal researchers decided to examine records from the Royal Victoria Hospital in Quebec and see what the impact of IVF had been on creating twins, triplets and other multiples.

Last year, Quebec established ainvi new policy that the government of the francophone province would pay for three cycles of IVF for people seeking it, but set a mandate of one embryo transfer at a time.

The Montreal doctors' study predates that policy, looking back at records from 2005 to 2007.

During that period, 17% of babies sent to the NICU, a total of 82 infants, were from multiple births resulting from fertility treatment. Seventy-five were from specifically IVF transfer of multiple embryos.

"Among these 75 babies, there were six deaths, five babies who developed a brain bleed, and four babies who developed a potentially blinding eye condition," said Barrington, a doctor at the University of Montreal.

Complications cut

If the rest of Canada were to follow the same one-embryo policy as Quebec, multiple birth rates and their complications could be drastically cut, the study argued, recommending that any regulation be accompanied by a policy of reimbursement for any additional costs to the parents-to-be.

"Since July 2010, all of the fertility centres in Quebec have adopted this approach, and preliminary results show that twin gestation rates have dropped from 30% to 3.8%," Barrington said.

Similar policy in the United States would result in even more benefits, because US doctors performed 20 times as many IVF procedures as in Canada in 2008, the study said.

About 1% of births in the United States are a result of IVF, which results in 16% of twin births and 38% of triplets.

(Sapa, April 2011)

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Child health

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