The evolving process of IVF
Mr Peter Bowen-Simpkins, Executive Medical Director of the LWC, who has spent much of his career in Wales, talks about the ever-evolving process of IVF that has happened during his career and his hopes for the future.
Q Since starting an IVF Clinic in Wales in the mid-90’s, how have things changed?
A The most staggering change is in success rates. When we started we were lucky to reach a success rate of 13%, yet now our success rates are over 45% for the under 35’s. Another significant change has been the introduction of ICSI in the 1990s. This technique of injecting a single sperm cell right into the heart of an egg revolutionised IVF, and male infertility has become a challenge of the past.
Q Have possibilities improved in terms of who can be treated?
A Before ICSI, our patients were largely female with problems affecting the fallopian tubes. But since then a whole range of different types of infertility have become amenable to treatment. Unexplained subfertility in patients, previously investigated, form a large group. In addition, as we have very large sperm and egg banks, we are able to offer treatment to those in a single-sex relationship and to single women.
Q What was your role prior to your appointment as medical director of LWC clinics?
A I was a consultant obstetrician and gynaecologist based at Singleton Hospital, Swansea. It was here that I extended my special interests in women’s health into fertility and IVF. We opened our first IVF Clinic in the mid-90’s and saw both NHS and private patients. Initially called the Cromwell fertility clinic, it became part of the LWC in 2005, and in 2012 these resources were combined in state-of-the-art, city-centre premises in Cardiff to form LWC Wales.
Q Is the patient demographic in Wales different to that of other areas?
A The population of patients in Wales is somewhat different from those found in the group’s London clinics in Harley Street and at the Bridge Centre. Most of our female IVF patients in South Wales are aged between 32 and 36, and most are couples having routine IVF and ICSI for infertility problems. In London we see slightly older patients, and more single women and same-sex couples. Here, age-related infertility is an increasing challenge.
Q What are your primary responsibilities as medical director?
A Ultimately the director has to ensure that whatever treatments are offered conform to the principles and standards of good medical practice. Monthly Clinical Governance meetings are held at which these are discussed. We pride ourselves on our pragmatic, common sense views and champion the treatment of single and lesbian women and older couples.
Q What’s the biggest challenge within your role?
A Even with our record success rates, there are still some patients who don’t have a baby. Subfertility is never an easy problem to deal with and we see couples investing much of their time, resources and emotions trying to resolve it. It’s hard to satisfy all of them, especially when the outcome is negative. But we give them reassurance that we’ve done all we can to the best of our ability.
Q What does the future of IVF hold?
A The future of course – as its always been in fertility – is constantly aiming to improve success rates by the introduction of new techniques. Presently, much hope is concentrated in the IVF laboratory and the promise that new techniques of genetic testing can improve the selection of embryos for IVF transfer. We see the application of these techniques as especially promising for older women and those with a history of recurrent miscarriage. Pregnancy loss is common especially in IVF, but we now have the promise of techniques to prevent it. It’s an exciting time right now in the IVF lab.
Q Apart from your work at the LWC how else do you support women’s health?
A I have been a Trustee of Wellbeing of Women for many years. It was formed by the Royal College of Obstetricians and Gynaecologists (RCOG) in 1964 and is the oldest and largest charity in the country researching specifically into women’s health. We raise money for research into pregnancy problems – such as miscarriage, premature labour and cancers, particularly ovarian cancer, and general health problems for women, such as heavy periods, the menopause and urinary problems. The charity works to improve the public’s awareness of the health issues affecting women at each stage of their lives. I was the Treasurer of the RCOG for seven years and latterly Treasurer of the Royal Medical Benevolent Fund.