Crystal ball gazing: fertility treatment in 2012

As the Christmas decorations were being safely stowed away for another year, BioNews asked if I would write a brief commentary to look forward into 2012. Crystal ball gazing has never been my strong suit but I found myself rising to the challenge now that I have taken over the mantle of Chairman of the British Fertility Society (BFS). In any case, what is clear is that 2012 should turn out to be an interesting year.

First on the horizon is the long awaited review of the National Institute for Health and Clinical Excellence (NICE) guidelines on the management of the infertile couple. Now in this I have to put my hand up and disclose an interest, because since 2011 I have acted as advisor to the committee that is undertaking this work.

You might imagine that this instantly gives me an inside track into what has been decided, but it does not. The NICE process is squeaky clean and I know very little other than the advice I have given. Clearly, we await news of what the committee has decided and what mix of investigations and treatments have been recommended. I am told that a six-week consultation process will begin in early February.

Although the provision of funding for infertility treatment has improved in recent years, the irony is that the 2012 review of the 2004 guidelines will take place before some parts of the country have even implemented the 2004 guidelines. This is still quite shocking and causes unnecessary heartache and strife to those couples involved. You can be certain that the BFS will be taking a careful look at these guidelines and will continue its work in campaigning for more equitable and equal access for NHS-funded infertility treatments.

Next on the horizon is what may happen to the regulation of assisted conception treatment and research currently overseen by the Human Fertilisation and Embryology Authority (HFEA). Toward the end of 2011, the Public Bodies Bill received Royal Assent, effectively giving ministers the powers to transfer HFEA functions to other bodies. Detail of how this might happen is currently lacking, but the BFS has already been involved in discussions with other stakeholders to try and influence the process as much as possible.

Our current regulatory system has served the sector reasonably well over the past 20 years, but in today's tough economic times it seems very reasonable to take a fresh look at what needs to be done and how it could be done better or more efficiently. Contrary to the ideas of a few commentators, no-one is arguing that the law should change; the principles of the Human Fertilisation and Embryology Acts need to be upheld.

But whether the current regulatory system is still the right way to go about this is a question that needs to be asked. Again, the BFS will be involved in these discussions and is happy to work with all concerned.

A common question I'm asked, usually by journalists seeking a scoop, is what research developments we might expect to see announced in the forthcoming year. Sadly, this is the hardest part of fortune telling as new research findings often come out of left field without much warning.

However, I have been impressed by several research groups recently who have been publishing data on their attempts to replicate the process of sperm production in the laboratory. BioNews readers may remember my initial scepticism when the first claims were made (reported in BioNews 601 - Mice sperm cells grown in the lab) but the data now is looking much more solid and encouraging. Perhaps we really are about to see the dawn of a new era in both understanding and treatment of male infertility.

Finally, we have a number of celebrations in the pipeline as 2012 sees a number of important anniversaries. First, we have the 40th anniversary of the World Health Organisation Special Programme of Research, Development and Research Training in Human Reproduction.

This has been the main instrument within the United Nations system for research in human reproduction, bringing together policymakers, scientists, healthcare providers, clinicians, consumers and community representatives to identify and address priorities for research to improve sexual and reproductive health around the world.

When we think of infertility, we often think of only our immediate locality but infertility and reproductive health is important to all nations and an infertile couple in the developing world will suffer the same heartache and anguish as couples in the UK. We should not forget this.

Secondly, 2012 sees the 60th anniversary of the first successful freezing of sperm with the publication in 1952 of the birth of a calf called Frosty from frozen bull sperm. Sperm freezing was rapidly employed in a variety of different areas of animal and human health and today is a mainstay technique of our ability to treat infertility and preserve the fertility of cancer patients.

Finally, the BFS itself will be celebrating an anniversary toward the end of the year given that it was in October 1972 that Patrick Steptoe first floated the idea of founding the society amongst his colleagues. We may have to wait until 2013 to bring out the bunting, but it certainly will be an interesting time to be Chairman.