THIS WEEK the Human Fertilisation and Embryology Authority (HFEA) said that we needed to reduce the number of hazardous multiple births caused by IVF.

Only 1 or 2 in every 100 natural conceptions results in twins; with IVF, the figure is 23 in every 100. The HFEA estimates that the deaths of 126 IVF twins could have been avoided had they been born singly. It is now consulting on the issue.

Multiple embryo transfer has always been justified on the ground that it maximises the chances of pregnancy. But research in 2004, involving 660 women in Scandinavian countries, began what was to become a torrent of evidence demonstrating that using one good-quality embryo can be as successful in assuring pregnancy as using two.

Some people claim these findings apply only to younger mothers, and insist that a single-embryo policy would be disastrous for older women. But last year a Finnish study showed that a similar rate of women over 36 and under 36 became pregnant with single replacement embryos – as long as they were carefully selected.

Significantly, this research comes from countries where adequate publicly funded IVF is available. And here lies the root of the reason why multiple embryo transfer has become so commonplace.

There is a tendency among some people to blame those who need IVF; they say it’s their fault for having children so late. But the truth is that many women have babies later because their plans didn’t work out as they thought.

When it does all go wrong, the pressure to have an “instant family” is intense, driven by a toxic combination of high cost (the average IVF cycle costs £5,000), a diminishing chance of success with every tick of the clock and, in some cases, by unscrupulous clinics anxious to boost league table results.

There is nowhere else for these couples to turn. Despite guidelines from the National Institute for Health and Clinical Excellence (NICE) that the NHS should offer three free cycles to couples under 39 with a proven fertility problem, many areas simply ignore them or impose impossible restrictions.

The irony is that, by its parsimony with IVF, the NHS is creating the conditions in which desperate couples clamour for multiple embryos because it seems to give them the best chance of success, thereby costing the NHS an enormous sum in the special care that 40 per cent of twins and triplets need after birth.

If more cycles were offered by the NHS, it would be in a better position to persuade the public of single embryo success.

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