[twinzplus3]

I was reading an article today and saw that the agency in the UK that governs fertility clinics is contemplating regulating the number of embryos that can be implanted during IVF, limiting it to one embryo at a time.
Here is the quote from the article (the article was actually about IVF babies being less healthy than babies conceived through other means

The Human Fertilisation and Embryology Authority is considering restricting the number of embryos implanted - to just one in most cases - in a bid to cut the number of multiple births. Dr Allan Pacey, of the British Fertility Society, said many of the health problems associated with IVF were linked to the high number of twins and other multiple births....

Is this a good idea or an infringements on couples rights? Do couples have the right to implant as many embryos as they want? Sticking to the debate rules. . .let's have a lively conversation!

[mcmama]

I don't know if I would limit it to one. Sometimes when people conceive multiples one makes it and one doesn't.

Two maybe, but not just one.

How many have they been implanting?

[wanttobemommy]

with IVF you have more of a chance to have success with two embryos. i think that they should not implant four or five. I think two is a good number. Just to give the couple a better chance to actually have the baby implant and stay. I think that if they limit it to one then they would need to lower the cost as well because there is no way to have a back up if that embryo doesnt stick then that whole cycle is a bust. And these cycles cost thousands of dollors to do

[twinzplus3]

I am actually really in favor of limiting it to one with few exceptions. Their exact wording was 'in most cases' they'd limit it to one. (I totally consider several embryos at once unethical and implanting two at once semi-borderline unethical.) But I was thinking about the cost being somewhat of a factor. I would be in favor of insurance paying more for fertility treatments actually. (But I admit I'm not really sure if insurance covers anything, something or what.) Or the cost being less.

[mrs_ray]

Hm. I'll give this one some thought and get back to you.

[pattiewrites]

I don't think implanting two is wrong. Twin pregnancies usually turn out just fine. It's not abnormal to me at all. Also, limiting to one baby is bad in terms of success rate. This isn't really fair to people paying $10,000+ for one cycle! In addition, the woman would likely have to endure more cycles with fertility drug injections. The procedure is more successful with two or more embryos. I think two or no more than three should be the limit. That would eliminate the need for selective reductions, even if they all took, which they usually do not.

I'd also like to see insurance cover more of the cost. Most plans have very limited or no coverage for infertility treatments of any kind. Massachusetts has a law that requires insurance companies to pay. I had heard that a few other states were considering following MA's lead on this issue, but I'm not sure if any have done it.

[pattiewrites]

Do you have a link to the actual article? I'd like to know why the babies are less healthy? Is it higher order multiples that are less healthy? If so, that's not really an IVF issue, but too many babies in the womb. It makes absolutely no sense that a single IVF baby would be less healthy than a singleton conceived the natural way.

[wanttobemommy]

Some states include fertility treatment in the coverage but most only cover the prescriptions. MA actually does have more coverage and I do think that insurance should pay more for fertility treatment. I think that two embryos is a good number for IVF because it at least gives you a better chance. Also there are going to be more successful IVFs if they allow two I can understand not doing 4 or more embryos but for the cost and the amount of time that it takes to do this type of treatment I dont think they should limit to one. I know that the chances of concieving multiples is rare but with IVF most people are willing to deal with the risks of multiples because they have waited for a child for so long. Honestly DH and I were saving for IVF because after two years my dr wasnt going ot give me any more clomid. I luckily concived without haveing to go through this but some women need this in order to have their dreams come true and to limit it to one would not only make the process more expensive but would make it more lengthy. My dr doesnt refer people to specialists until two years without concieving. So there is a min of two years before you can see a specialist than they usually want to run all the tests again which can take months and months because they can only do some tests on certain cycle days. Then they want to try a combo of meds than IUI and then IVF the process takes long enough.

[twinzplus3]

Originally Posted by pattiewrites

Do you have a link to the actual article? I'd like to know why the babies are less healthy? Is it higher order multiples that are less healthy? If so, that's not really an IVF issue, but too many babies in the womb. It makes absolutely no sense that a single IVF baby would be less healthy than a singleton conceived the natural way.

Pattie, I'm not sure that I do have the original link. I think I read this online out of the newspaper (as opposed to reading the actual journal). But I agree with you. Did you read my blog on this?

At the end I make mention of how I'd like to see more variables separated out. IMO, the study would really need to consider only full term singleton IVF babies in order to say that IVF babies are less healthy. I didn't see that they did that. I'll try to dig for a link today if I get a chance.

[twinzplus3]

[quote=pattiewrites] Twin pregnancies usually turn out just fine. [quote]

This is only half true. Less than 10% of women carry twins full term. Twins don't grow the same in utero as singletons do and so even twins born full term are more likely to be low birth weight babies with the various associated health risks. Twins are twice as susceptible to RSV, developmental disorders and delays and I haven't even started talking about the risks to mom. (But I will concede that many twins do grow and are just fine

I wouldn't necessarily consider it unethical to implant two embryos for women who are more likely to go full term (which really in a twin pg is very hard to predict. . .even very healthy women with healthy pg are high risk for preterm labor) but I hate the idea that it's considered an 'easy two for one deal'. It is not two for one and it's not easy--I just don't think people get it.

I guess the existential question here is when is it considered to do 'harm' to the mom and babies? Certainly creating a scenario where the babies will be premature should be considered 'harmful'. Putting a mother at risk for gestational diabetes, severe diastasis requiring surgery, heart problems, etc. should be considered 'harmful' as well. Regardless of the patient's wishes. JMHO