Overhaul UK fertility law to keep up with advancements, expert says

A leading fertility expert has said the law should be overhauled so that rapid advancements in reproductive science do not stall.

Prof Tim Child of the University of Oxford said IVF in the UK was “the most successful and the safest that it has ever been”, and noted that the chance of having a baby from a single embryo was rising and the likelihood of having multiple births dropping.

According to figures from the Human Fertilisation and Embryology Authority (HFEA), birth rates for patients under 35 were 32% per embryo transferred in 2019, compared with just 9% in 1991.

Over the same period, the average rate of multiple births for all women undergoing IVF has fallen from 28% to just 6%.

But Child, who is medical director of the Fertility Partnership, the UK’s largest assisted conception network, and chair of the HFEA’s scientific and clinical advances advisory committee, said a review of the 1990 Human Fertilisation and Embryology Act was needed to ensure that new developments in reproductive science can be considered more quickly.

This comes after the Guardian revealed that the first UK baby created with DNA from three people had been born, using a technique known as mitochondrial donation treatment.

While the science behind the treatment is undeniably impressive, Child said a significant achievement was the way it had been handled in the UK, with public consultation and consideration by parliament.

“It was all done in a very robust way to consider which clinics should be allowed to offer this treatment and also then the mechanism by which patients can access the treatment – so in a very safe, measured and regulated manner,” he said.

“I think the breakthrough really has been the way that this has been done in a scientifically and I think ethically robust manner. But importantly, that it has been allowed.”

Nevertheless, Child said, the law needed to be overhauled to ensure the UK was “proactive and reactive in the right blend” for new developments coming in, “so we’re not holding things up, but also we continue to do things in a strong, robust manner”.

He said: “When the act was written, it was just impossible to foresee the advances that have been made over the last 30-plus years.”

The HFEA is consulting on how regulation can be improved.

Child said: “I absolutely do think that there are many scientific advances out there, there will be many more to come, and that the regulatory environment in the UK should be improved so that these advances can be considered perhaps more quickly.”

Among possible changes to the framework, Child mooted the approval of scientific advances without parliament having to necessarily consider each case separately. But he stressed that did not mean that everything would be permitted.

“Many scientists will be pushing for things that perhaps it’s not right to allow at the moment, or it’s not something that society wants to consider at the moment,” he said.

Child said that among the scientific developments on the radar of the HFEA’s Scientific and Clinical Advances Advisory Committee, as part of their “horizon scanning” process, were genome editing – a process that could allow a faulty gene to be replaced – and synthetic gametes, in other words eggs or sperm that are made in the laboratory from other types of cells.

Artificial intelligence could also prove beneficial, he said, for example in scoring embryos for IVF – a process by which embryos are graded according to their growth rate and other measures, to help clinicians choose the best embryo to transfer.

Among the other areas being looked at, said Child, is the rule that embryos can be cultured for only 14 days from a research perspective.

“There is a consideration as to whether, from a scientific perspective, that should be pushed on further to try and increase the understanding of what goes right or wrong with embryos,” he said, adding that could be helpful both for fertility treatment and for improving outcomes in complicated pregnancies.

Child added that the wealth of areas where research was booming made it an exciting time.

“And from a UK science environment, we are looked upon, absolutely, as having some of the best scientists in the world,” he said.

“A lot these things are done first in the UK, but very importantly in a very safe [manner] for patients and also for society.”