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Cheap fertility drugs warning

21st April 2010

Bill Ledger, Professor of Obstetrics and Gynaecology at Sheffield University, writes on the BBC News website about the danger of using low-cost fertility treatments to help women conceive.

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It is certain that giving birth to a single child in each pregnancy is better for a woman and her child than a multiple birth.

Having more than one baby per birth means an increased danger of premature delivery, illness and in some cases a disabled child.

The number of women who gave birth to twins and triplets in the 1990s in the UK soared due to well-intentioned fertility practitioners who transferred multiple embryos following IVF.    

Fertility medication requires stricter regulation. Although the "high tech end" of fertility medicine is strictly controlled in the UK, any doctor is able to issue a prescription for this medication.

The Human Fertilisation and Embryology Authority (HFEA) has striven to stop three embryo transfers for women under the age of 40.

As a result, the number of triplet births has decreased and the HFEA is now attempting to acheive a reduction in the amount of twin embryo transfers.

Although the number of multiple births from IVF multiples has gone down, a fresh difficulty has appeared.

Many concptions occur following treatment with medication which induces ovulation, such as clomifene (Clomid) or injections of FSH(follicle stimulating hormone).

These drugs must be more strictly controlled. Any doctor can issue a prescription for this type of medication, although it is recommended that they are used in a hospital by knowledgeable staff.

We should not "clamp down" on this treatment, as this will cause more people to go abroad for treatments which are not regulated.

We need to understand the "deeply felt need" that many couples experience when infertility enters their lives.

If this is not taken into account then women will buy Clomid online or have huge amounts of FSH abroad, then come back home pregnant with triplets.

We should inform couples that the best option is having "one at a time" and ensure that infertile couples are given treatment by the health service so they can decide what is best medically, rather than financially.

The amount of twin pregnancies can be maintained at under 10% with the use of tablets and injectables, although this number has not yet been achieved in IVF in the UK.

However this will need patients to be closely monitored. An ultrasound scan can show whether a woman is in danger of having a multiple birth.

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