Inquiry launched into success rates of fertility clinics

Regulators are to scrutinise Britain's fertility clinics to find out why some are four times more successful than others at helping couples to have babies.

The Human Fertilisation and Embryology Authority (HFEA), which licenses the clinics, will publish figures today showing the live birth rates achieved at 75 centres offering in-vitro fertilisation (IVF) techniques.

The figures show a huge variation in the success rates of different units, with a number of clinics achieving live births in more than 40 per cent of the IVF cycles.

At some units, fewer than 15 per cent of treatments resulted in live births and one clinic had a success rate as low as 10.5 per cent. Nearly all the clinics had success rates of between 20 and 30 per cent for women of all age groups and slightly better outcomes for women under 38.

The HFEA, which is publishing the data on its website, stressed that clinics with lower success rates might not provide poorer-quality treatment. They could be treating more difficult patients, such as older couples and women with complex medical histories, while clinics with good results could be selecting patients with the most promise of pregnancy or transferring more embryos into a woman's womb.

To investigate the discrepancies, the HFEA will now audit the patient records held by all clinics to check that the live birth data submitted to the authority is correct.

Professional bodies, such as the British Fertility Society and the Royal College of Obstetricians and Gynaecologists, will also be consulted about why some clinics do better than others.

Suzi Leather, the HFEA chairman, said she was "reasonably confident" of the accuracy of the latest figures. But she warned: "It would be highly embarrassing for a clinic to be discovered submitting inaccurate results."

The figures show a slow but steady rise in the number of women having babies after IVF treatment, which can cost £2,500 to £3,500 per cycle. In the year ending March 2001, 21.8 per cent of IVF treatment cycles resulted in a live birth, with a higher rate of 25.1 per cent for women under 38.

This compares with a 19.5 per cent birth rate across all age groups in 1998-99 and 22.1 per cent for women under 38.

More older women are also having treatment because of the trend towards later marriage and childbirth. One quarter of women starting IVF treatment are now 38 or older compared with 22 per cent four years ago.

Ms Leather said the age of a woman was the "single most important factor" in determining whether a couple would succeed in having a baby and one drawback in delaying childbirth was that the discovery of any underlying reproductive problem would thus be delayed. She added: "Having said that, we are not saying that women should try earlier. Women have to make their own decisions based on what is right for them."

To avoid the risk of multiple births, British clinics should usually transfer no more than two embryos into a womb, but they can implant three in "exceptional circumstances". Ms Leather said inspectors would monitor the proportion of three-embryo transfers to make sure clinics were not stretching the rules.

Some countries such as the Netherlands, where more couples receive state-funded IVF, have moved to single-embryo transfers and Ms Leather did not rule out a similar move in Britain.

One of the most successful clinics is University College Hospital, London, where Paul Serhal, the medical director, said the live birth rate had trebled in the past decade because of "fine-tuning" in laboratory techniques.