Popular IVF add-ons fail to help women get pregnant, fertility regulator warns
Popular IVF “add-on” treatments fail to help women conceive and in some cases harm their chances of having a baby, the fertility regulator has warned.
A new traffic light system intended to protect desperate families from unscrupulous clinics has applied “red light” warnings to four of the 10 most commonly purchased procedures.
These include so-called “assisted hatching” which uses lasers to help the embryo hatch, and pre-implantation genetic screening (PGS), which the watchdog says risks damaging fragile embryos by cutting into them while testing for abnormalities.
Meanwhile the remaining six treatments, such as endometrial scratching and embryo glue, carry an “amber” designation, meaning that research has indicated some benefit but more robust evidence is needed.
Some of the add-on procedures are costing patients up to £3,500, on top of a price tag of around £5,000 for the IVF itself.
The website’s launch comes alongside publication of a new code of conduct requiring fertility clinics to inform patients about the paucity of evidence behind many of the therapies they offer.
It also demands an end to the culture of secrecy among some private providers which limits the ability of watchdogs and academics to assess how well or not various treatments are working.
However, the document, which has the backing of the 11 professional bodies including the Royal College of Obstetricians and Gynaecologists, is not legally enforceable.
It comes as increasing numbers of would-be parents are self-funding IVF because of rationing by the NHS.
The National Institute for Health and Care Excellence says women with fertility problems should get three cycles of IVF on the NHS, however just 11 per cent of health authorities now achieve this.
Sally Cheshire, Chair of the HFEA, said: “It’s crucial that patients inform themselves about the add-ons they may be offered, so that they can ask the right questions, and make the right choices, when choosing what treatment to have.
“We’ve produced traffic light rated information on our website that keeps them up-to-date with the latest evidence on each of the most commonly offered add-ons.”
The HFEA website applies an “amber” warning to pre-implantation genetic screening at five days after fertilisation, but “red” after three days.
The process involves checking embryos for abnormalities in the number of chromosomes that may indicate a high chance of miscarriage, stillbirth or a disorder such as Down’s Syndrome.
However, doing this involves removing cells from the embryo which may damage it and prevent it successfully developing in the womb.
Studies have shown that this type of PGS can reduce the chance of a having a successful pregnancy, according to the HFEA.
The website also flags concerns about intrauterine culture, a process whereby fertilised eggs develop in a device which is then inserted into the woman’s womb for several hours, only to be removed and transferred back to the womb at a later date.
The regulator says this misses the point that, at that early stage of conception, the embryos are supposed to be in the fallopian tube, not the womb.
Jason Kasraie, Chair of the Association of Clinical Embryologists, said: “We support greater transparency in the sector with regard to treatment add-ons.
“Whilst it is important that we work to ensure patients always receive the latest treatments and have access to new technologies in order to maximise their chance of treatment success, it is also essential that we ensure patients are fully informed and that only procedures or technologies that are evidence based are used.”
The 10 popular IVF add-ons rated on the HFEA website:
RED - assisted hatching
RED - intrauterine culture
RED - pre-implantation genetic screening at three days
RED - reproductive immunology tests and treatment
AMBER - artificial egg activation calcium ionophore
AMBER - elective freeze all cycles
AMBER - embryo glue
AMBER - endometrial scratching
AMBER - pre-implantation genetic screening at five days
AMBER - time-lapse imaging
