Treatment add-ons

ivf_science-300x168If you are currently having fertility treatment, you are likely to be aware of the many different additions that are offered on top of the standard IVF from immunology treatments to time-lapse imaging. Yesterday’s Independent contained three articles on the subject;  a news story, details of some of the treatments which may not be evidence-based and an editorial suggesting that clinics should not be offering unproven treatments. It is worth reading if you are thinking of having treatment.

It is to be welcomed that the Independent are exploring this issue – it is something which has been a concern to many of those supporting patients for some time as more and more additional treatments are offered in fertility clinics, just a few of which are listed in the paper. Patients are often worried that if they don’t pay for extras they will be reducing their chances of success, when there isn’t a strong evidence base to support this as the leading experts quoted in the articles explain.

I’m not entirely sure I agree with the editorial though, which seems to put some of the blame for this back at the door of fertility patients with the suggestion that  “We also live in an age in which people do not like to take no for an answer. Some couples may be reluctant to face the fact that there may be no simple answer to their fertility issues. If one treatment does not work, the temptation is to demand another.”.  Patients are not likely to demand different treatments if clinics don’t offer them, and it seems to me unfair to be blame patients for the fact that clinics are offering unproven treatments. In fact, the editorial does go on to say that “the onus lies on the clinics – not the patients – to be the voice of realism“. It also claims that only a quarter of women who have IVF conceive – this may be true of an individual cycle of treatment but cumulative outcomes are far higher – many of those who conceive after IVF treatment did not get pregnant in the first cycle.

If you are having fertility treatment and are being given the opportunity to pay for additional extras, it is really important to make sure that you are clear about the evidence. The best kind of evidence comes from a randomised controlled trial (an RCT) and it is always a good idea to ask whoever is treating you to point you in the direction of evidence in the form of an RCT to suggest that paying for an extra treatment is a good idea.

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