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Human Fertilisation and Embryology Bill [HL]

There is a great deal of technical information in the Bill. We have gone through much of it this afternoon and this evening and will go through more. It might be useful and for the benefit of the Committee to discuss Amendment No. 62 in the name of the noble Lord, Lord Alton, on ovarian hyperstimulation syndrome. This is an extremely puzzling condition. It is essentially a response of the ovary to stimulation by the hormone which is given exogenously; that is, by injection, to women whose eggs are needed for IVF. One of the problems about this puzzling condition is that women respond idiosyncratically; that is, some women with a very low dose of FSH—the hormone involved—give a very exaggerated response which is quite unpredictable. Other women, in spite of massive doses of the hormone, do not give this response at all and do not show ovarian hyperstimulation. You could argue physiologically that virtually all IVF cycles are a form of ovarian hyperstimulation because that is the nature of the beast. Humans were built to ovulate one egg and in order to improve the statistics to get more embryos so that one will be viable there is pressure to get more than one egg in the hope that you will get one embryo. So this is a major problem. While I have great sympathy with the concern of the noble Lord, Lord Alton, about women who are made sick by this technology, I do not consider for a moment that this is because there is a drive in the background to stimulate women so vigorously that one gets lots of eggs for research; rather, it is an attempt to maximise the chances of a successful pregnancy. The problem is that the two issues are not related, so you can get large doses of hormones and small numbers of eggs and vice versa. The symptoms of OHSS vary massively. For example, thrombosis, which I agree is a dangerous condition, very often is totally silent, women are not admitted to hospital and they do not even know that they have a thrombosis. Some years ago, the noble Lord, Lord Jenkin, and I sat on a Select Committee looking at the aircraft passenger environment. One of the major issues with which we were concerned was thrombosis after long flights. We saw from the evidence that most of the thromboses were not detected and were not detectable unless you involved subjects—aircraft passengers—in detailed tests. That is a key problem here with OHSS. No matter how carefully the records were taken, they would actually be completely unreliable. Secondly, there is the important issue that was just raised by the noble Baroness, Lady Deech. As the noble Baroness pointed out, a large number of people come from overseas for these treatments, spend a variable amount of time in the United Kingdom, may be hospitalised overseas and may be hospitalised here. It would be inappropriate to try to keep those sorts of records. It would be an unreasonable burden when there are much more important records that we might be considering; for example, the children born as a result of this treatment, which is not in the Bill. I referred to that at Second Reading. I feel that while we in the medical fraternity understand the concern, at present one has to say that this extremely puzzling and common condition is not predictable and does not routinely end in hospitalisation. One of the reasons why the royal college and the HFEA figures vary so much is that there is no definition of severe ovarian hyperstimulation. That is a real issue if you are going to try to keep records.