# Guardian - Guy's and St Thomas' hospital paper on blastocyst's



## Shellebell (Dec 31, 2004)

Fertility clinic boosts safety and success· Pregnancy rates rise with use of more mature eggs
· Doctors hope to avoid risks of multiple conceptions

Sarah Boseley, health editor The Guardian, Thursday February 21 2008 Article history · Contact us Contact usClose Contact the Society editor
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Advertising guide License/buy our content About this articleClose This article appeared in the Guardian on Thursday February 21 2008 on p5 of the UK news section. It was last updated at 00:05 on February 21 2008. 

A British fertility clinic has halved the rate of multiple births and increased pregnancy rates by allowing embryos created in the laboratory to mature for longer before they are returned to the womb.

The success of the assisted conception unit at Guy's and St Thomas' hospital in London may suggest a way ahead for other clinics trying to give women the best chance of a baby without increasing their chances of a multiple pregnancy, which carries significant risks.

There is concern about the number of twins being born after in vitro fertilisation. About a quarter of women who are successfully treated have multiple pregnancies. Compared with single births, twins are seven times more likely to die and six times more likely to suffer from cerebral palsy, which causes huge distress to families and incurs high costs for the NHS.

At the moment clinics usually return two or three embryos to the womb rather than one, to increase the chances of a pregnancy. In younger women (those under 35) especially, this carries a high risk of multiple birth but one which many are happy to take. Most couples cannot get NHS funding for more than a single IVF attempt, so many are keen to conceive twins on a "buy one get one free" principle.

In a paper published today in BJOG, the journal of the Royal College of Obstetricians and Gynaecologists, scientists at Guy's and St Thomas' reveal their success in cutting multiple births without damaging the chances of pregnancy by returning to the womb a single blastocyst - a fertilised egg that has been dividing for five days instead of the usual two or three. A fertilised egg that reaches the blastocyst stage in the lab in more likely to implant in the womb and lead to a live birth.

Dr Yakoub Khalaf, director of the unit, said they mounted an education campaign to tell women of the potential problems of multiple births. "We educated ourselves and our staff about the risks," he said. "This is a serious issue. The heartache is palpable. Every day we see patients losing their twins at 22 and 23 weeks. Then we imparted this message to our patients."

Some 2,400 women were involved in the three-year study. Half were offered a single blastocyst and the majority - not all - accepted. The other half were offered two or three early-stage embryos.

The team found that offering blastocyst transfer improved the results of the entire unit. The multiple pregnancy rate dropped from 32% to 17% - nearly half. The pregnancy rate rose, from 27% to 32%.

"It is a myth that single embryo transfer lowers the success rate of pregnancy," said Khalaf. "If the right patients are selected for blastocyst transfer, success rates can be maintained and multiple pregnancy can be significantly reduced."

Fertility doctors urged that more funding be made available to encourage couples not to take the risk of multiple pregnancy. The National Institute for Healthcare and Clinical Excellence recommended in 2004 that all couples should be funded for three IVF attempts, but few primary care trusts pay for more than one. Mark Hamilton, the chair of the British Fertility Society, said central funding for more attempts would save the NHS millions in the costs of care for premature and sick babies.

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## anna the third (Jan 15, 2008)

God - what are Guys and St Thomas playing at? 

This doesn't make any sense at all. 

If half of the sample included women with 3 implanted, that half included women over 40. That success rate is tiny so it is skewing downwards the whole results of that half of the study. 

No surprises the other half of the study with one blastocyst (implanted into a younger group of women) did much better.

They aren't comparing like with like, a basic element of any study i would have thought. They are just trying to provide evidence for their economically driven desire to have no option of double transfer for anyone. 

This is really awful and we should all oppose it.


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## Betty M (Dec 6, 2005)

here is the paper itself:
http://www.blackwell-synergy.com/doi/full/10.1111/j.1471-0528.2007.01584.x

The study looked at all their IVF patients. The first group was all their IVF patients between July 2004 to Dec 2005 when they didn't do blastocysts soo plenty of younger women would have been in that group. The other group were those where - "Between January 2006 and June 2007 cycles in which there were a minimum of four 8-cell cleavage-stage embryos with less than 10% cytoplasmic fragmentation21,22 on day 3 were offered extended embryo culture until day 5 to allow further development of these embryos and transfer of a single blastocyst if a high-quality blastocyst17 was present. We continued to offer transfer of up to three embryos for women where the cohort of embryos did not satisfy these criteria."

Betty

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