The Human Fertilisation and Embryology Authority's public consultation "The Best Possible Start to Life" was published in April 2007. It set out the options for reducing the incidence of multiple births following in vitro fertilisation. Following the consultation the authority concluded that a three year strategy was needed to enable the multiple birth rate to fall. They have called on the relevant professional bodies to lead on developing guidance on the best way to achieve this change. We have welcomed that work, which will be taken into account by the expert group which we are establishing to consider the barriers to the implementation of the National Institute for Clinical Excellence fertility guideline and assess how to help primary care trust commissioners.