Friday, February 13, 2009

Authoritarian British medicine being evaded

Women should be allowed to have some say in their own risks but in Britain you are just expected to obey commands from on high. The vast majority of IVF births are fine with or without Britain's draconian restrictions

CHILDLESS British women who travel abroad to have up to four embryos implanted in their wombs have been given an official warning about the health risks. The "embryo tourists" are going overseas to circumvent rules on multiple IVF births. Some women return expecting triplets or quadruplets.

Professor Lisa Jardine, who chairs the Human Fertilisation and Embryology Authority (HFEA), says women are damaging their health and exposing their babies to harm. The authority says the women are also burdening the NHS by becoming pregnant with more than one baby. The watchdog is now investigating how to tackle the practice. Jardine said: "It is our job to make sure that this deeply felt need [for a child] does not result in people putting their health at risk. "People who seek treatment outside the UK often do so because they believe this will allow them to make choices about their treatment which are not available in the UK. These might include selecting the sex of their baby for nonmedical reasons, or having a higher number of embryos transferred, in spite of the widely recognised risks associated with multiple pregnancy. "My deep concern is that, in the belief that they are widening their choices, such people are also removing themselves from the help and protection that responsible regulation provides [That's a laugh1]. We are looking closely at whether there is more we could do to protect and inform those who choose to travel abroad for fertility treatment."

In the past few weeks, one woman has returned to Britain with quadruplets after fertility treatment in Israel, while last year a woman who returned to Leeds with triplets after fertility treatment in India lost all three babies.

Professor Alan Cameron, past president of the British Maternal Fetal Medicine Society and a consultant obstetrician at the Queen Mother's hospital in Glasgow, said: "I see the impact of this almost weekly. My colleagues in the neonatal units are going to hate me when I make that call to say we have triplets who look like they are going to appear early, and that has an impact on neonatal units and neonatal costs."

In Britain, a maximum of two embryos can be transferred to a woman below the age of 40. Women aged above 40 are allowed three embryos. The HFEA has, however, introduced quotas on the percentage of multiple births permitted at each clinic to make single embryo transfer the norm. From last month, only 24% of births at each clinic are permitted to be multiple births including twins, triplets and quadruplets. The percentage must drop to 10% in three years' time.

Adam Balen, professor of reproductive medicine and surgery at Leeds general infirmary, said: "[Multiple births] result in women coming into hospital, sometimes for many weeks on end because of threatened premature labour." Balen, who is also a spokesman for the Royal College of Obstetricians and Gynaecologists, said: "The reality of a premature delivery is babies born who need neonatal intensive care and run the risk of either sadly dying or being left with a significant handicap such as cerebral palsy."

The Medical Board of California is investigating the fertility treatment given to Nadya Suleman who gave birth to octuplets last month. Suleman, 33, who has six other children through fertility treatment, had six embryos transferred at a clinic in California. Two of them split to create the octuplets. American Society for Reproductive Medicine guidelines say only one or two embryos should be implanted in a women of Suleman's age. The octuplets, although apparently healthy, were born nine weeks prematurely by caesarian section and are expected to remain in hospital for several more weeks.

Mandy Allwood, the British mother who became pregnant with octuplets in 1996 after taking fertility drugs without medical supervision, lost all eight babies. Allwood, who has since attempted to take her own life, has spoken of her mixed emotions at the safe birth of the American octuplets.


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