Warning issued to UK fertility clinics
There is 'no conclusive evidence' that specific additional fertility treatments help women get pregnant, yet many clinics are charging upwards of £3500 for these extras
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The UK IVF regulator has issued a warning to fertility clinics over expensive secondary treatments for which there is little evidence and may in fact harm chances of conception.
The Human Fertilisation and Embryology Authority (HFEA) analysed 11 available 'IVF add-ons' to find out how effective each one is.
It found five of the supplemental treatments had 'no conclusive evidence' that they worked at all.
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As part of a new traffic light system, five treatments (listed below) have been given a 'red' warning.
'Red' warning fertility therapies
RED: Assisted hatching
Where the outer shell of an embryo is 'cracked' before it's placed in the womb, to help it expand and implant into the uterine wall. However, evidence shows this may damage the embryo.
RED: Intrauterine insemination
In low sperm count cases, high quality sperm is injected into the uterus. While there is little risk attached, there is no evidence to suggest it helps.
RED: Reproductive immunology tests/treatment
Suppression of the immune system with drugs to avoid an immune 'rejection' response. However, risks include high blood-pressure, diabetes and premature birth.
RED: Intracytoplasmic morphologic sperm injection (IMSI)
High quality sperm is injected directly into the egg. Again, the procedure is non-invasive but there is no evidence to show that it works.
RED: Physiological intracytoplasmic sperm injection (PICSI)
The identification of high quality sperm. This is also non-invasive but has no proven effectiveness.
Source: Human Fertilisation and Embryology Authority (HFEA)
Six other treatments - artificial egg activation calcium ionophore, elective freeze all cycles, embryo glue, endometrial scratching, pre-implantation genetic screening (PGS) and time-lapse imaging have been given an 'amber' warning, meaning the treatment has shown some promising results in early trials but requires further research:
'Amber' warning fertility therapies
AMBER: Artificial egg activation calcium ionophore
When chemicals called calcium ionophores are used to stimulate fertilisation. However, these chemicals can lead to miscarriage.
AMBER: Elective freeze all cycles
Fresh embryos are frozen before insemination at an optimum point in a cycle. There are no risks, but some embryos may not survive the freeze.
AMBER: Embryo glue
Believed to help embryos attach to the uterine wall. There are no known risks, but no evidence to say it works, either.
AMBER: Endometrial scratching
It is believed scratching the womb lining makes it more receptive to implantation. However, if there was an infection in the cervix, the procedure could allow it to spread to the uterus.
AMBER: Pre-implantation genetic screening (PGS)
Screenings for abnormalities in embryos. However, this can cause embryo damage.
AMBER: Time-lapse imaging
Photos of embryo development identify those with the highest chances. While there are no risks, there isn't any evidence to suggest it works either.
Source: Human Fertilisation and Embryology Authority (HFEA)
No additional treatments have been given a 'green' light, which means the HFEA 'does not think any of these techniques should be used.'
According to the NHS, the cost of IVF itself starts at £5,000 per cycle. Additional treatment costs can vary depending on which clinic you're with and what treatment you want.
According to IVI UK, a company specialising in assisted fertility treatment, embryo glue costs £550, Physiological intracytoplasmic sperm injection is £1,200, and uterine insemination is £750.
The HFEA's new code of conduct says fertility clinics must tell patients how effective each therapy is to allow them to make an informed decision.
It is also urging clinics and private providers to allow watchdogs and academics to assess how well the various treatments offered work.
Though the document has been supported by 11 professional bodies, including the Royal College of Obstetricians and Gynaecologists (RCOG), it is not legally enforced, which means every clinic has the right to choose whether they stick to the code or not.
HFEA chairman Sally Cheshire said: 'It's crucial clinics are transparent about the add-on treatments they offer, including the potential costs, to ensure patients know exactly whether they are likely to increase their chance of having a baby.
Chief executive of the Fertility Network charity, which provides advice to anyone going through fertility problems, Aileen Feeney, supports the HFEA's new code of conduct.
She said: 'Knowing whether or not to include fertility add-ons is a very emotionally charged and financially difficult decision to make.
'Patients are often very vulnerable after years of trying to become parents – that's why it is crucial for fertility clinics to behave ethically and not offer false hope or up-sell treatment add-ons.'
Have you had an additional IVF treatment? How much did you spend and did the treatment work? Tell us in the chat thread, below.
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