Mail.co.uk - IVF experts should encourage twin births not cap them, says controversial doctor

Women could be denied the chance of having a baby by new restrictions on the number of multiple births, a leading fertility expert has warned.Norbert Gleicher, one of America's most successful IVF doctors, said the capping of twin and triplet pregnancies could result in fewer women fulfilling their dream of motherhood.The strategy, devised by Britain's fertility watchdog to reduce the risks associated with multiple births is 'categorically wrong' and 'dramatically misguided', he said.Instead of avoiding twin pregnancies, fertility clinics should be actively encouraging them, he added.Speaking at a fertility conference, Dr Gleicher said one twin pregnancy was no more dangerous than going through two separate single pregnancies.Having twins is also no more costly - and the increased earning power of two bodies rather than one may even benefit the economy in the long-term, his research suggests.What is more, having twins gives couples an 'instant family', removing the need for a woman who has struggled to conceive a first time to get pregnant again.But Dr Gleicher's comments, which are based on his review of more than 15 years of fertility studies involving thousands of twin and single births, have been hotly disputed by fertility doctors in the UK and abroad.
Fertility rowIn a joint statement, experts, including Professor Peter Braude, of King's College, London, said twins face 'huge obstetric complications', some of which can lead to a lifetime off suffering.Loss of one or both babies during pregnancy is a source of 'profound disappointment' which has no monetary value, they said.Concerns about the added risks of twin births has led to the country's fertility watchdog to the cap the number of embryos implanted at a time to one wherever possible.Twins are at much greater risk of stillbirth and cerebral palsy than their single counterparts. They are also much more likely to be born prematurely, placing extra pressure on an already cash-strapped NHS.Mothers are at a greater risk of developing pre-eclampsia, a life-threatening complication of pregnancy, and are three times more likely to die during childbirth.
With twin births accounting for one in four IVF pregnancies, The Human Embryology and Fertility Authority says the policy of single embryo transfer, which is due to come into from January 2009, will benefit both mother and child.But Dr Gleicher, of the Centre for Human Reproduction in New York, said the thinking behind the policy was fundamentally flawed because it simply compared the dangers of having twins to those of carrying a single baby.Factoring in the risks associated with becoming pregnant a second time cancels out the dangers of a twin pregnancy, he said.Medical costs are also unlikely to be higher in a twin pregnancy and women will benefit because they will only need to go through one set of IVF treatment.He told the European Society of Human Reproduction and Embryology's annual conference in Barcelona that limiting transfer to one embryo at a time would cut pregnancy rates, which are already lower than those in the US.'Single-embryo transfer does reduce pregnancy chances and therefore if the UK does go through with this process you will see a further decrease in pregnancy rates,' he said.'I and most of my colleagues are driven by what our patients are telling us. We strongly believe that nothing is more important to an infertile patient than getting pregnant and it is our principle responsibility to help them get pregnant quickly and safely.'But Professor Braude, who helped shape the HFEA's policy, urged caution, questioning Dr Gleicher's calculations and saying his conclusion 'flew in the face of all published data about the risks of twin pregnancies'.In a joint statement with other fertility experts, Professor Braude added that Dr Gleicher had not fully account for all the medical and emotional problems associated with twin pregnancies.'The saddest outcomes that we see in practice are those twin pregnancies where women go into very premature labour or lose both babies at around 25 weeks or less,' they said.'The disappointment and grieving that accompanies this loss is profound and cannot be calculated in dollars or pounds.'Whatever the hypothesis, which may be interesting for doctors to mull over and discuss, there are significant risks to multiple pregnancies and we should not be generating them deliberately.'IVF babies also deserve the best start in life.'