A new ratings system from the HFEA, the fertility regulator, in the UK has revealed that certain fertility treatment “add-ons” do not always improve the chances of having a baby
This comes after concerns were raised about clinics offering expensive and unproven treatments. To address this, experts are emphasising the importance of clinics providing clear information on costs and success rates. Support groups are hopeful that these ratings will help alleviate some of the stress associated with buying private fertility treatment.
So what is an add on?
Add-ons are optional treatments that can be offered alongside proven fertility treatments like IVF.
Examples of IVF add-ons might include:
- Pre-implantation genetic testing (PGT): This involves testing embryos for genetic abnormalities before they are implanted. PGT can help identify healthy embryos for transfer but is not always necessary for all IVF patients.
- Assisted Hatching: This technique involves creating a small hole in the outer shell of an embryo (zona pellucida) to help it hatch and implant in the uterus. It’s believed to improve implantation rates.
- Endometrial scratching: This procedure involves intentionally injuring the lining of the uterus before embryo transfer, with the idea that it may promote better embryo implantation.
- Time-lapse embryo imaging: Continuous monitoring of embryo development through time-lapse imaging is claimed to help select the best embryos for transfer.
- Intralipid therapy: Intralipid infusions are sometimes offered to women with recurrent pregnancy loss. These infusions contain fat emulsions and are thought to have an immune-modulating effect.
These add-ons are often marketed as enhancements or options to improve the chances of a successful IVF outcome. However, their efficacy and value have been a topic of debate and controversy within the medical community, as some of these add-ons may not have strong scientific evidence supporting their effectiveness.
The HFEA’s updated fertility treatment add-on rating system now has five colours that indicate whether the regulator considers the treatment effective.
– Green with a plus sign suggests the treatment is effective.
– Yellow with a plus-minus symbol – it is not clear whether the add-on is effective due to conflicting evidence.
– Grey with a question mark means the HFEA cannot rate the effectiveness due to insufficient evidence.
– Black with a zero in the middle suggests that the add-on has no effect on fertility treatments.
– Red with an exclamation mark means that there are potential safety concerns over the add-on and the treatment may even hamper a couple’s chances of getting pregnant.
Fertility Network UK, a patient-focused charity and support organisation based in the United Kingdom has welcomed this new system but has highlighted that none of the listed add-ons have been rated green. They encourage patients to carefully consider all the information provided before making any decisions.
Professor Tim Child, who chairs the HFEA Scientific and Clinical Advances Advisory Committee, explains that while certain treatment add-ons may be beneficial for specific patient groups, for the majority of patients, undergoing more rounds of proven treatment may be more effective.
Dr. Catherine Hill, head of policy at Fertility Network UK, acknowledges the emotional and financial challenges that patients face when making decisions about costly fertility treatment add-ons. She stresses the importance of patients looking into all the information available before making any decisions.
The HFEA emphasises that patients should not be kept in the dark, and add-ons without strong evidence of safety or effectiveness should only be offered as part of research. Chief executive Peter Thompson states that clinics must provide patients with clear explanations of what any treatment add-on entails, its likelihood of increasing the chance of a successful pregnancy, and its cost. They should also provide a link to the HFEA ratings system.
