Fertility Treatment (Hansard, 31 March 2004)

§ Miss Melanie Johnson

The Human Fertilisation and Embryology Act 1990 provides a regulatory framework for the provision of treatment involving in vitro fertilisation (IVF) and human embryo research. These activities are licensed by the Human Fertilisation and Embryology Authority (HFEA). Inspection of licensed establishments is the cornerstone of the HFEA's work to ensure compliance with Act, the HFEA's code of practice and the conditions upon which the establishment's licence has been granted.

It is not a simple matter of an establishment either "passing or failing" a HFEA inspection. Licensed establishments are expected to operate to set standards and regular inspections take place to ensure these standards are maintained. Where an inspection team considers that an establishment needs to make improvement in a certain area of its operation, a HFEA licence committee that considers the inspection report may decide to attach additional conditions to the licence, with a deadline for implementing improvements if necessary. Failure to comply with the conditions of a licence would be considered by a licence committee and could lead to the revocation of the licence. Were practice to be found of so poor a standard that patients were placed at risk, a licence committee would, as a matter of urgency, consider suspension of the licence and, if necessary, revocation.

The HFEA code of practice sets out standards of conduct and practice that licensed establishments are expected to observe. The new edition of the code, which came into force on 1 March 2004, limits the number of eggs or embryos that can be placed in a woman under age 40, in any one treatment cycle, to a maximum of two. The purpose of this is to limit, as far as possible, multiple pregnancies, which can have a significant medical and social impact on the resulting children and their families, as well as having cost implications for the national health service for the care of the mother and babies. This guidance is supported by the National Institute for Clinical Excellence's guideline on fertility treatment which also recommends that ovarian stimulation should not be offered where the female patient has no fertility problems herself to prevent the risk of a multiple pregnancy. Together these measures should reduce the number of multiple births.

There are no plans to require licensed treatment clinics, a number of which operate within the NHS, to reimburse the health service for costs resulting from the care of multiple pregnancies and births.

The Government have not commissioned any research into the long term effects of in vitro fertilisation (IVF). However, the HFEA has been working with the Medical Research Council to determine what follow-up studies may be needed to assess both the treatments used and any long-term health implications for patients and children born as a result of fertility treatments, including IVF.

When considering applications for embryo research, members of the HFEA are required to reach decisions on the basis of a fair and impartial assessment of the 1517W facts. The HFEA only licences embryo research to take place in circumstances specified by the Human Fertilisation and Embryology Act 1990 and in accordance with the requirements of the Act. No HFEA members have expressed objection to the principles in the Act.

Compliance with the prohibition in section 3(4) of the Human Fertilisation and Embryology Act 1990 on the keeping or using in treatment or research of embryos beyond the 14 day limit is monitored though the HFEA inspection process.

Section 3A of the Human Fertilisation and Embryology Act 1990 prohibits the use in fertility treatment of eggs taken from aborted fetuses. There are no plans to change this. Under the Human Tissue Bill storage of fetal tissue for research purposes would be subject to licensing by the Human Tissue Authority.