New research commissioned by BBC’s Panorama and conducted by Oxford University claims that nearly all additional treatments offered by UK fertility clinics have no scientific evidence to support their success.
Infertility affects about one in seven couples, with IVF being an expensive but potentially successful way to start a family. A single cycle can cost £5,000. The financial costs to couples soon adds up when extra add-on treatments are offered, from screening blood tests to egg freezing – which could cost an extra £8,000.
But are these additional, expensive, treatments helpful? New research suggests most add-ons have no supporting evidence based on up-to-date information.
The new research, published in the British Medical Journal, looked at whether any of the treatments affected the live birth rate. Only one add-on treatment - endometrial scratching – had supporting evidence of an increase in live birth rate, and even that was only of moderate quality.
Prof Carl Heneghan, director of the centre and who led the team, told Panorama: “It was one of the worst examples I've ever seen in healthcare.
“The first thing you would expect to happen is that anything that makes a claim for an intervention would be backed up by some evidence.
“Some of these treatments are of no benefit to you whatsoever.”
Example of costs for interventions additional to standard IVF (Source: BMJ)
- Individual screening blood tests—start at £50
- Embryoglue—up to £160
- Intralipid infusions—up to £250
- Endometrial scratch—up to £325
- Assisted hatching—up to £450
- Blastocyst culture—up to £800
- Time lapse imaging—up to £850 for the Eeva time lapse incubator, up to £800 for the Embryoscope
- Intracytoplasmic morphological sperm injection (IMSI)—up to £1855
- Percutaneous epididymal sperm aspiration/testicular sperm extraction (PESE/ TESE)—up to £1600
- Preimplantation genetic screening—£3500
- Egg freezing packages—up to £8000
The BMJ website states: “Guidance from the UK regulator, the Human Fertilisation and Embryology Authority (HFEA), suggests questions that couples might want to ask before deciding on treatment. These include:
- Is this treatment recommended by the National Institute for Health and Care Excellence (NICE) and, if not, why not?
- Has this treatment been subjected to randomised controlled clinical trials that show it is effective and is there a Cochrane review available?
- Are there any adverse effects or risks (known or potential) of the treatment?”
A report on the BBC website states: “Panorama found many patients are still willing to pay for unproven treatments, even when their clinics tell them there is no high quality evidence behind them.
“One patient told the programme: ‘I think if someone said if you cut off your hand you'll have a baby, I think I would have done it.’”
We spoke to the British Fertility Society (BFS) about the research. Professor Adam Balen, Chair of the BFS and spokesperson for the Royal College of Obstetricians and Gynaecologists (RCOG), said:
“The field of reproductive medicine and IVF is evolving continuously and the UK has led the world with research into fertility treatments.
“New treatments and approaches are always being evaluated and it is important that patients receive full information about everything that is being offered, the current evidence for benefit and whether there are any side effects or risks associated with it.
“It is the role of the BFS and of healthcare professionals to support and provide reliable information on any treatment being considered and those looking after fertility patients have their best interests at heart.
“Some treatments need further and higher quality research into their effectiveness which will add to the existing evidence base and better inform patients.
“Currently the NHS does not provide adequate funding for fertility treatments, contrary to NICE recommendations. The BFS is actively campaigning to improve the situation nationally and abolish the postcode lottery. Many patients are required to self-fund treatment and so it is essential that they are made clear exactly what they are being charged for.”
The BFS produces a number of patient information leaflets offering up-to-date information and explanations of complex scientific topics at britishfertilitysociety.org.uk
Have you had IVF? Did you pay for additional treatments? Tell us your experiences in the comments box below