What Impact Does "Fertility Tourism" Have On The NHS?

Main Category: Fertility
Also Included In: Pregnancy / Obstetrics
Article Date: 19 Sep 2008 - 9:00 PDT

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New research presented at the Royal College of Obstetricians and Gynaecologists (RCOG) 7th International Scientific Meeting in Montreal has looked at the impact of higher order multiple pregnancies (triplets or above) within the NHS and the link with fertility treatment received overseas.

In the United Kingdom it is recommended that, where possible, only one embryo is transferred per IVF cycle to reduce the incidence of multiple pregnancy. Multiple pregnancy is linked to serious complications for mother and baby including significantly increased risks of pre-eclampsia, hospitalisation, premature labour and birth, intrauterine death and neonatal mortality. However, in many countries there is no limit to the number of embryos transferred and little regulation of fertility services.

The study, from the Fetal Medicine Unit at University College London Hospital (UCLH), included 109 women with higher order multiple pregnancies of which 15 had conceived naturally and 94 had received fertility treatment. Of those who had fertility treatment, 25% received it outside of the UK.

The research found that women who received fertility treatment overseas were significantly less likely to opt for embryo reduction than those who were treated in the UK - a rate of 33% compared to 51%.

The reasons for overseas treatment included the cost in the UK, that the country was their home, a better success rate due to higher number of embryo transfers overseas, faster speed of treatment and the availability of an acceptable ethnic donor.

The authors have expressed concern due to the serious complications associated with high order multiple pregnancies, as well as the financial implications for the NHS due to additional antenatal care, increased maternal hospitalisation and increased neonatal care.

It is suggested that as assisted reproductive technology becomes more available governments and relevant regulatory and professional bodies should seek consensus on harmonising safe and ethical fertility treatment across borders.

Dr Alastair McKelvey, Subspecialty Fellow in Materno-Fetal Medicine at University College London Hospital and lead author of the study said, "Triplet, quadruplet and higher order multiple pregnancies are very challenging high-risk pregnancies. We were concerned, through personal experience, about the extent of this problem and its link to unregulated fertility care on the world market.

"The information revolution and globalisation have radically changed many aspects of life - including medicine and access to it. National regulatory bodies can be sidestepped by couples desperate for a baby and the myriad of tempting offers of fertility treatments can lead them to serious adverse consequences.

"This research suggests that international agreement on this aspect of women's health - preferably by professionals - is needed."

The Royal College of Obstetricians and Gynaecologists 7th International Scientific Meeting is taking place in Montreal from Wednesday 17th until Saturday 20th of September. The meeting is being held in conjunction with the Society of Obstetricians and Gynaecologists of Canada and the American College of Obstetricians and Gynecologists.

For further information and to see the scientific programme please visit: http://www.rcog2008.com/index.cfm.

Royal College of Obstetricians and Gynaecologists