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New legislation proposed in the U.K. will introduce tighter regulations for in vitro fertilization (IVF) procedures and potentially decrease the number of IVF-related abortions. The legislation, if passed, will prohibit doctors from implanting more than one embryo at a time in women under 40. Including the statistics for women over 40, who could still receive more than one embryo, this would mean that the chances of multiple pregnancies would drop from 25 percent to 10 percent, decreasing health risks for both fetuses and mothers.

Doctors usually transfer multiple blastocysts—embryos made up of 80 to 100 cells—at a time to a patient's uterus. The Human Fertility and Embryology Authority (HFEA), which regulates U.K. fertility clinics, allows doctors to implant two embryos in women under 40 and three in women over 40. Transferring more than one embryo increases the likelihood of a pregnancy, but it also increases the likelihood of multiple pregnancies.

For mothers, carrying more than one fetus presents an amplified risk of life-threatening conditions such as diabetes and heart attacks. It also presents risks to the fetuses, who are more likely than single babies to be stillborn, to die in the first week of life, to be disabled, or to be born prematurely. "For the children's sake and the mother's sake, there is less risk in putting in one [embryo] at a time," said Dr. David Stevens, family practice physician and chair of the Christian Medical and Dental Association.

Frequently, when more than one transferred embryo implants, doctors recommend that women "selectively reduce" their pregnancies, aborting one fetus in order to give the other one a better chance of survival. If the number of multiple pregnancies could be reduced, doctors would perform fewer selective abortions.

"I'm pleased [the U.K. is] moving toward less risk of multiple pregnancies, which is really what this is about," said Nigel Cameron, director of the Center on Nanotechnology and Society at the Illinois Institute of Technology and president of the Institute on Biotechnology and the Human Future. Cameron noted, however, that the legislation "is not out of concern for embryos; it's out of concern for multiple pregnancies and the problems they cause for fetal health as well as maternal health."

Albert Mohler, president of Southern Baptist Theological Seminary, agrees that the legislation is not about life ethics. "Nothing here is gained in terms of the status of the embryo," he said. "As a matter of fact, this could very well lead to even larger numbers of human embryos that, given the policies of the HFEA, are destined not only for interim storage but for long-term destruction."

Cameron said proposed legislation springs out of the British government's biomedical policies. "Britain has taken the lead globally with a very liberal approach to what you can do with embryos, but it has a very strong regulatory nature."

While the legislation is beneficial in the sense that the proposed law would decrease health risks for mothers, limiting the number of embryos implanted does have its drawbacks. "The downside of this legislation is that it may preclude a small number of women and their spouses from having children, as it may require more attempts in successive cycles and time may run out before they are successful," said Hessel Bouma III biomedical ethics expert and biology professor at Calvin College.

According to Stevens, although the legislation is likely to pass in the U.K, it is unlikely that a similar measure would be introduced and passed in the U.S. anytime soon. "Our country has this unspoken right to reproduction," he said. "[Most people believe] no one should tell you anything about having your children." Ultimately, Stevens says, this is not a helpful presupposition, as it has prevented the reproductive health industry from governmental regulation.

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April (Web-only) 2007, Vol. 51