Key Facts – In Vitro Fertilisation
In-vitro fertilisation (IVF) involves the creation and implantation of a number of 4-8 cell stage embryos in to the uterine wall of women who, for whatever reason, have had difficulties conceiving naturally.
The procedure has several different variations depending on the exact assisted reproductive technologies/new reproductive technologies (ARTs/NRTs) used. ARTs presently used include:
- Intra Cytoplasmic Sperm Injection (ICSI)
- Sub-Zonal Sperm Injection (SUZI)
- Gamete Intafallopian Transfer (GIFT)
- Zygote Intrafallopian Transfer (ZIFT)
The Human Fertilisation and Embryology Authority (HFEA) was established in 1991 under the 1990 Human Fertilisation and Embryology (HFE Act); its remit being to “license and monitor UK clinics that offer IVF (in vitro fertilisation) and DI (donor insemination) treatments and all UK-based research into human embryos…[and to] regulate the storage of eggs, sperm and embryos.”
The forthcoming HFE Act 2008 continues this remit, containing regulation for all aspects of IVF and its associated technologies. Key areas of regulation with regards to IVF involve:
- The number of eggs/embryos that may be transferred to the uterus
- Storage of gametes/embryos
- Issue of ‘parenthood’ of the embryo
Multiple embryo transfer:
A number of high profile cases of pregnancies of large numbers, such as the Alwood and Suleman octuplets, have introduced calls for centres to reduce the number of embryos transferred during IVF treatments.
In the UK, the 2008 HFE Act specifies that centres must now establish standard operating procedures with regards to the minimisation of multiple births, aiming for single embryo transfer (SET) wherever possible.
If more than one embryo is to be transferred:
- If a woman is under 40 and using her own eggs or embryos, the centre may transfer no more than 3 eggs or 2 embryos.
- If a woman is over 40, the centre may transfer no more than 4 eggs or 3 embryos.
The woman must also be warned of the risk of multiple births (and associated complications) associated with such transfer.
The standard period of storage for embryos and gametes is stated as being 10 years., although, specific exceptions may warrant licenses for both shorter and longer periods of storage.
The 2008 Act includes instructions for a 12 month “cooling off period” should one gamete donor withdraw their consent for continued storage.
At the time of birth of a child(ren) conceived as a result of IVF, its mother is defined as:
The woman (W) who is carrying or has carried a child as a result of the placing in her of an embryo or of sperm and eggs, and no other woman.
The child’s father is defined as W’s husband automatically or partner as long as both parties provide consent for him to be treated as such.
In the event of female civil partnerships, W’s partner is classed as the legal parent of the child(ren), providing effective consent were established at the time of insemination.
In the event of surrogacy arrangements, parental orders may be applied for by the intended parents to obtain full custody of the child(ren).
Debate still rages with regards to IVF treatment of women beyond the normal age of menopause, with no official ‘upper age limit’ currently existing in the UK.