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Fertility specialists warn against unnecessary, expensive treatments

23 May 2016
Appeared in BioNews 852

A number of fertility specialists have raised concerns over private clinics offering expensive 'add-on' treatments to patients, sometimes without sufficient evidence of their effectiveness.

In a series of interviews with The Independent, some of the leading experts in the field of assisted conception claim that clinics are handing out expensive, and 'potentially harmful' treatments 'like Smarties', and they criticise the industry for announcing 'breakthroughs' that were sometimes closer to marketing 'hype'.

The UK's fertility regulator, the Human Fertilisation and Embryology Authority (HFEA) also told the newspaper that it has become 'increasingly concerned' about IVF 'add-ons'.

Speaking to The Independent, Professor Martin Johnson, emeritus professor of reproductive sciences at the University of Cambridge, said that some treatments used at fertility clinics suffered from 'a lack of scientific rigour'.

'What it means is the treatment could be making their situation worse and certainly not improving it – and is costing them money. It's all about anecdotal evidence or no objective evidence,' he said.  

One of the 'add-on' treatments that has been highlighted is an immune-suppressing treatment to prevent the embryo from being rejected by the mother, with several experts raising concerns about potential harmful consequences of this form of intervention.

Ashley Moffett, professor of immunology at the University of Cambridge, told The Independent: 'There's certainly no evidence that this does any good, and there is the potential that it can do harm because these treatments are immunosuppressive.'

Dr John Parsons, founder and former director of King's College Hopsital's Assisted Conception Unit and a trustee of the Progress Educational Trust, which publishes BioNews, said the increasing number of women waiting longer to have children and then seek help when they do not conceive has created a 'perfect storm' for fertility doctors at the moment.

'They often become desperate for help, even though the best thing to do is to keep trying to conceive naturally, and they'll pay money for treatments that they don't really have,' Dr Parsons told The Telegraph.

Dr Parsons said that some women are offered add-on treatments that have not been sufficiently tested by private providers when IVF fails to work. 'An awful lot of these clinics would not be financially viable without offering people these treatments,' he said.

Other add-on treatments have also been criticised, including preimplantation genetic screening, time-lapse photography and the use of intrauterine insemination, according to The Independent. Fertility treatment has seen only a slight rise in the IVF success rate of 26.5 percent in 2013 from 20 percent ten years previously (see BioNews 845), despite new treatments regularly being offered.

The HFEA told The Independent that it is working on providing information on additional treatments so that people are able to make informed decisions about whether or not to accept 'extras'.

Sally Cheshire, chair of the HFEA, said: 'Although the vast majority of clinics provide excellent care for fertility patients, we are becoming increasingly concerned about IVF treatment "add-ons" without a strong evidence base being offered at some clinics.'

However, the chairman of the British Fertility Society, Professor Adam Balen, said that clinics were already informing couples appropriately, providing information about the nature of the treatment and success rates.

He also argued that clinics were providing scientifically founded treatments only. 'All of these treatments have been tested around the world and have been studied in clinical trials – every single one. None have been shown to do harm,' he told the Mail Online.

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