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Twin dilemma

BMJ 2014; 348 doi: (Published 02 January 2014) Cite this as: BMJ 2014;348:f7603
  1. Sophie Arie, freelance journalist
  1. 1 London, UK
  1. sophiearie{at}

What will the ending of targets on numbers of multiple births for UK fertility clinics mean for patients and the NHS? Sophie Arie reports

Mohammed Taranissi is a successful infertility specialist. Thousands of women whom he has helped to conceive sing his praises, but he has also attracted controversy and had several clashes with the fertility sector’s regulatory body, the Human Fertilisation and Embryology Authority (HFEA). Nonetheless, his methods have been vindicated and he has won several lawsuits against his critics.

Now, Taranissi has won a legal battle with implications reaching far beyond his own reputation and practice. He has forced the HFEA to back down in its attempt to make clinics reduce the number of twins and triplets they produce.

In 2009, the HFEA set targets calling on the industry to reduce the rate of multiple births arising from in vitro fertilisation from 24% of all IVF births in 2009 to 20% in 2010, 15% in 2011, and 10% in 2012.1 In 2011, the HFEA threatened to remove licences from clinics that failed to meet the targets and by 2012 the IVF multiple birth rate had fallen significantly from 24% in 2009 to 16.9%. Although no clinic that failed to meet the targets had lost its licence the HFEA believed the threat helped motivate clinics and it was working closely with the “outliers” to bring their figures down.

But Taranissi, whose two London clinics have some of the highest success rates in the country but also have high rates of multiple pregnancies,2 appealed against the HFEA targets, arguing that it was unfair to impose the same targets on all clinics because they have different types of patient. He also argued that the HFEA was interfering with clinical judgment.

After a long legal battle Taranissi won an appeal …

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