IVF twins risk

New research suggests that twins born after IVF are more likely to be premature and to have health problems than twins conceived naturally. Although it has been known for some time that twin pregnancies carry additional risks for mother and babies, it has often been assumed that these are risks for any twin pregnancy, no matter how it began. Now it seems that the risks are greater for IVF twins although it isn't clear why this should be.

It's yet another argument for moving away from multiple embryo transfers wherever possible - I think that fertility patients have often been misled about the risks of twin pregnancies by consultants who are focused on pregnancy rates. We should be pressing for more affordable and more successful treatment so that single embryo transfer becomes the perfectly acceptable norm for younger women who are deemed to have a good chance of success.

You can read more about the research, which is published in Human Reproduction at http://humrep.oxfordjournals.org

Embryology errors

Earlier this month, newspapers were reporting problems in the embryology labs in the IVF unit at Guy's, where it was alleged that eggs had been fertilised with the wrong sperm and had to be destroyed. There was a great deal of criticism of the unit and of the HFEA for failing to regulate and monitor such problems.

When I was researching The Complete Guide to IVF , I spent time watching embryologists at work, and one of the things that really struck me was how rigorous the witnessing procedures are in labs in order to ensure that mix-ups don't happen. Two embryologists would double-check everything whenever eggs, sperm or embryos were moved from one part of the lab to another and there seemed little room for error.

However, we all make mistakes and even the best systems sometimes go wrong. What we should be noting about the incidents at Guy's is that they were immediately reported to the HFEA. This is good practice and is the only way embryologists can learn from one another to try to prevent any future problems. It would be a great shame if the fact that honest clinic staff, those who admit to their mistakes, end up in the firing line leads to others being more wary about being honest themselves.

Interviews...

I've done quite a few interviews over the past month for my new book The Complete Guide to IVF . I've rather belatedly discovered a link to this one from the London Evening Standard

UK's first fertility law firm

If you think you might need legal help for any fertility-related problem, you will be interested to know about the launch of the UK's first ever fertility law firm. Gamble and Ghevaert specialises exclusively in fertility and parenting law, and will be able to offer advice to anyone who is trying to conceive through fertility treatment or in non-traditional family structures.

The firm is founded by fertility lawyers Natalie Gamble and Louisa Ghevaert who have recognise the need for legal support in sometimes complex and unchartered areas - for example where parents are starting families with surrogates, using donor gametes or travelling overseas for fertility treatment.

Natalie Gamble is a leading fertility lawyer who has championed the rights of fertility patients, and was last year nominated by gay rights organisation Stonewall as a Hero of the Year for her work supporting the new rights for gay and lesbian parents. Louisa Ghevaert is an experienced family law litigator with a specialism in fertility and children's law.

You may want to look at the firm's website, www.gambleandghevaert.com for helpful information about fertility and parenting law

How old is too old to be a mother?

So, a single woman of 66 is set to be Britain's oldest mother after having fertility treatment at a clinic in Ukraine - the kind of news that sets alarm bells ringing about unscrupulous IVF clinics, and allows for ethical debates about the rights and wrongs of helping women in their sixties to have babies.

It's true that we wouldn't raise our eyebrows very far at the prospect of a 66 year old man fathering a child, and it could be seen as sexist to be condemning a women of that age for wanting to have a child of her own. However, the very real risks for both mother and child of pregnancy at this age should not be underestimated.

What I can't understand is why it would take someone so long to realise that they wanted a baby? Surely, if you were so keen to get pregnant that you managed to arrange to go through donor treatment overseas in your late sixties, you could have done this at least ten years earlier...

Not quite so rosy in Scotland after all...

Scotland has often been praised for a forward-thinking attitude to infertility, but new evidence is emerging that maybe the picture north of the border isn't quite as rosy as imagined.

Depending on where you live, you can wait for as long as three years for IVF treatment, and the upper age limit also varies from one area to another. This postcode lottery means that two patients who are due to receive treatment at the same fertility clinic may wait for just a few months to have IVF if they live in one area, but two or three years if they live elsewhere. There are also differences in the number of cycles of treatment offered, with some health boards offering just two rather than the recommended three. There's even confusion over frozen embryo transfers, which are counted as separate treatment cycles in some parts of Scotland.

You can read more on the story at www.theherald.co.uk

Call for fertility funding in Wales

Campaigners are trying to persuade the Welsh Assembly to honour guidelines set down by the government's advisory body and fund up to three cycles of IVF treatment for eligible couples.

In some parts of the country, the guidelines set down by NICE are now being followed, with up to three cycles of funded treatment. Campaigners in Wales feel this is far from becoming a reality where they live - the most they can hope for under the current regime is one attempt at IVF funded by the NHS.

If you'd like to find out more about the campaign, to sign the petition or to get copies from organiser Kara Ellard you can see www.walesonline.co.uk

The problem of infertility in Africa

We often think of infertility as a problem of the Western developed world - and when it comes to sub-Saharan Africa, news tends to focus on the problems of high fertility rates rather than those who have difficulties getting pregnant.

Now, an anthropologist from Brown university in the States has published some fascinating research about the stigma of infertlilty in Nigeria where the lack of understanding and sympathy that some women who can't conceive face can be shocking. In certain areas, infertile women are treated particularly badly - they are not regarded as proper women and often find they are forced to live on the margins of society. Their fertility problems frequently lead to divorce and financial difficulties. The researchers say that "the necessity for a woman to have a child remains basic in this region. Motherhood continues to define an individual woman's treatment in her community, her self-respect, and her understanding of womanhood." I wonder quite how different we really feel it is here...

You can read more about the research at www.scienceblog.com