Question time

'People go on holiday and the cash is gone.' Mohamed Taranissi, the UK's most successful fertility doctor, on why a baby is a bargain at £10,000

Your IVF clinic, the Reproduction and Gynaecology Centre in London, has just been named the most effective in the UK and your success rate is twice the national average. Why ?

A lot of it is based on commitment, a lot of hard work. We work seven days a week. A lot of places are five days a week. They have set days to do egg collection, embryo transfer and so on.

How much is due to multiple embryo transfer?

In this country you cannot put more than two embryos [back into a patient], and that's what most people do. People need to understand the reality and the facts: yes, there is an increased risk [of complications] but the vast majority of the twins and so on are perfectly OK.

So why do people worry about it so much?

If you carry multiple babies there is a much higher chance of prematurity, going into pre-term labour - that's the problem, not the actual presence of two. If you have two and they go to term, there's no problem. The uterus is not supposed to keep two babies for nine months, but there is a lot of improvement [in the care] given to pre-term babies. It's a difficult call because in an ideal world, yes, you'd like people to become pregnant with one, which is the nearest to nature, but you don't want to take drastic measures that will affect their chances of getting pregnant in the first place.

Why is the Human Fertilisation and Embryology Authority (HFEA) so hostile to you?

All I know is that I concentrate on my work. I'm a bit outspoken because I speak my mind, and sometimes people don't like that because they are not used to it.

What is it about your practice the HFEA takes issue with?

I don't know. We have a long history. It's not something that is new. The way I speak and express myself sometimes is not the normal English way and people sometimes take is as you being aggressive or disrespectful. I may get emotional about things; it's not meant as disrespect to anybody.

Is what you do new and pioneering, or is it experimenting on people?

I don't know. There are a lot of techniques that we do in IVF that there is no evidence for. There are a lot of things we do in medicine that are not backed up by clear-cut scientific evidence. What matters is the answer - either people are pregnant and have babies or they are not. You cannot argue with that. Most of these people have failed several times.

Why is IVF so expensive?

If you walk away with a baby, you cannot say £10,000 is a lot of money. People go on holiday, spend a few thousand pounds and it's gone.

Should there be more IVF on the NHS?

Of course. People pay enough tax here to get whatever treatment they might need. I know people argue infertility is not a disease but it is. Most of the time it's a reflection of some other underlying condition which is a medical condition.

There is an image that fertility doctors are slightly seedy.

Everybody in this world who does a job gets paid for it. I don't understand why there should be a big stigma. It's an open market.

Are women leaving it too late to have children?

You don't need to be a doctor to understand that as you grow older your fertility potential will reduce. Everybody knows that. If people start early their chances will be much better, even if they have problems. If you have two patients, one who is 30 and one who is 40, and they have exactly the same medical problems, the one who is 30 will definitely have a much better chance. It's as simple as that. But we live in a real world and people have got commitments and financial constraints and careers and all sorts of things so that's why things happen the way they happen.

Do you ever turn women away?

I don't turn people away as such but my job, as I see it, is to try and clarify a medical situation for the couple, make sure they understand exactly what is possible and what is not possible. But the decision should always be theirs. I don't think I should say, "We're not going to treat you." I should say, "The chances are very small because you've got this, this and this. If you know this and you want to go into the treatment with open eyes, fine, I'll do my best."

Do you not have a responsibility to say no?

It's not for me to say yes or no. If you have a 1% chance, does this mean you should not have treatment if you understand that your chance is 1%. Why should this be taken away from you?

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