Quintuplets - should this really be a success story?

I've just been reading about a "miracle" birth in the States, where a woman has given birth to quintuplets after fertility treatment.  The tiny babies were born at 28 weeks and are apparently "critical but stable".  It is so very sad that anyone who has had to go through the traumas of not being able to conceive should then have the further trauma of premature babies spending weeks if not months in intensive care in hospital. The babies are in an intensive care unit that has just recently been caring for sextuplets, born to a couple who had IUI.

No reputable fertility professional should be putting the lives of babies and mothers at risk by carrying out treatment which results in the conception of five or six babies at once.  We are only hearing about the babies which make it as far as being born, albeit prematurely, but it would be far more common to miscarry when so many embryos implant at the same time.

In the early days of fertility treatments, when specialists were still unsure quite how women's bodies would react to fertility drugs, such multiple conceptions may have been more understandable, but there is no need for anyone to take such risks any more - and any fertility specialist who boasts sextuplets or quintuplets on their CV should be avoided as they certainly don't have their patient's best interests at heart.

Why sextuplets are not a good idea...

If you've thought about travelling abroad for fertility treatment and have maybe wondered whether the relaxed regulations in other countries might be part of the attraction, think again... I've just been reading an article about a woman in the States who has given birth to sextuplets after fertility treatment - ten weeks early. Five of them are apparently doing "as well as can be expected", which given their prematurity and very low birth weights will undoubtedly mean problems ahead. The sixth baby faces "greater challenges". Their mother was offered "selective reduction", which is a way of dealing with bad decisions made during fertility treatment, but felt unable to take that option. In this particular case, it wasn't that too many embryos had been transferred during IVF. These sextuplets were the result of IUI. In this country, when a fertility specialist stimulates the ovaries during IUI, the treatment is tailored to aim to produce one or at most two eggs. Any responsible specialist would immediately stop treatment if there was a danger of this this kind of risky high-order multiple pregnancy. According to the article I read, there are as many as 2,000 cases of selective reduction each year in the States, and it's little wonder that there is sometimes such vehement opposition to fertility treatment. The fact that it is "hard to regulate" IUI seems to be the excuse - but surely it is time for fertility specialists to face up to the consequences of the treatments they are offering. Our system in the UK is not without faults, but it's only when you see what can happen in other places that you realise quite how lucky we are. See the article in question here

Is fertility treatment selfish - an interesting response..

I’ve just been reading a really interesting piece written by a mother of twins who expores very honestly the self-consciousness she sometimes feels about her children who were conceived using IUI. She tells how people feel no qualms about asking whether her children were conceived naturally and what an invasion of privacy this can seem.

She also addresses the criticism so often thrown at people who can’t conceive naturally that using fertility treatment is somehow “selfish” and that adopting would be a more socially responsible way to deal with the problem. The wild comments under any story about fertility treatment often imply that couples with fertility problems simply don’t think about this and that we are wound up in some feverish consumerism which makes us believe we have the right to anything we want. In fact, this couldn’t be further from the truth and couples going through fertility treatment tend to think a lot about their desire for a child and what it means, as this article so clearly explains…

The treatments that don't work for unexplained infertility

It seems that two commonly used fertility treatments are a waste of time when they're used to treat couples with unexplained infertility. A research project in Scotland looked at the use of Clomid (clomifene citrate) and IUI (intra-uterine insemination) and concluded that they neither of them really made much difference to the chances of conceiving.

The study followed 580 women with unexplained infertility. Some were prescribed Clomid, some were given IUI and some weren't given any treatment at all. Perhaps surprisingly, the lowest pregnancy rates were amongst the group who took Clomid. Although the IUI group did have a slightly higher pregnancy rate than those who had no treatment, the research team say the differences are small enough to be statistically meaningless, and have concluded that there may be no medical justification at all for prescribing Clomid or attempting IUI in women with unexplained infertility.

No one would want to be given a treatment that isn't going to work, and we must welcome any research that looks into the efficacy of fertility treatment. However, it does worry me that this may make it easier for local trusts to cut their spending on infertility yet further - at the moment many will pay for Clomid and IUI, but not for IVF. If they decide to stop spending on Clomid and IUI for unexplained infertility, I fear they are not going to increase their spending on IVF, and some couples may find that they can't access any kind of treatment at all. What's more, commissioners may start to assume that couples with unexplained infertility would all get pregnant eventually if they left it to Nature. I know from personal experience of more than 13 years of unexplained infertility, that this is not the case. So although it's helpful to know that these treatments may not be much use if you don't know why you aren't getting pregnant, it may not be so helpful if you end up not being able to access any other treatment instead.

You can read more about the research which is published in the BMJ at www.bmj.com