Research question
How are IVF clinic websites advertising three common IVF add-ons: assisted hatching, time-lapse embryo imaging and preimplantation genetic testing for aneuploidies (PGT-A)?
Design
The Human Fertilisation and Embryology Authority ‘Choose a fertility clinic‘ website service was used to identify IVF clinics and their websites. Assisted hatching, time-lapse embryo imaging and PGT-A were examined to determine which websites advertised them, what price they charged and what claims they made in relation to the add-ons.
Results
Eighty-seven eligible clinics were identified, with 72 unique websites; 37 (43%) clinics were part of one of nine groups of IVF clinics, of sizes ranging from two to eight clinics in the UK. Time-lapse imaging (TLI) was the most frequently advertised of the three add-ons (67% of clinics), followed by PGT-A (47%) and assisted hatching (28%). Very few websites stated that the effectiveness of the add-on was in doubt or unclear (four, two and one websites for TLI, PGT-A and assisted hatching, respectively), and none raised the possibility that an add-on might have negative effects. Claims of efficacy were often based on upstream outcomes (e.g. implantation, pregnancy). Some claims that PGT-A and TLI improved live birth rates were found. There was substantial variation in pricing.
Conclusions
IVF clinic websites provide valuable information for patients seeking fertility treatment so it is key that the information is accurate and complete. There is a need for transparent information on interventions, including uncertainties and risks, to be made available by IVF clinics to support well-informed treatment decisions. The selected add-ons are widely advertised, and there is wide variation in pricing.
Although IVF and egg freezing have received much scholarly attention, the pivotal role of financialization in the fertility (preservation) sector remains understudied. This article discusses how processes of financialization have instigated a step-change in the organization of contemporary US IVF and why egg freezing is at the heart of a wider consolidating trend in the sector. The financialization of fertility, in this context, references the financial investments in a future in which ever more women freeze their eggs, the role of capital markets in establishing new clinical and commercial infrastructures through which egg freezing becomes accessible and the role of financial products in shaping both the stories and the streamlining of fertility treatments. Together, these developments signal a shift from reproduction to fertility in IVF, in which treatment is not aimed at having a child at present, but rather at the proactive management of a more speculative fertility throughout the life course.
In the last decade, two influential new reproductive technologies have been introduced that are changing the face of in vitro fertilization (IVF): egg freezing for “fertility preservation” and time-lapse embryo imaging for embryo selection. With these technologies emerge alternative visual representations of the assisted reproductive process and its relation to time. First, frozen egg photographs provide a lens onto contemporary reconfigurations of reproductive aging and stage a life-death dyad between the frozen cell and the embodied self, which drives treatment rationales for egg freezing. Second, time-lapse embryo imaging creates visual recordings of developing embryos in the incubator; the resultant quantified visual information can then be repurposed as a tool for predicting embryo viability. As these two sets of prenatal images reference dying eggs and non-viable embryos, they demonstrate a necropolitics of reproductive time, in which not only the generativity of new life but also the encounter with the death, finitude and fallibility of reproductive substances drives a widespread and intensified engagement with reproductive technologies.
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