Impact of an Early Pregnancy Education Packet on Patient Question Volume

Abstract

OBJECTIVE: ''Add-on''procedures are actively promoted by some fertility clinics as proven means to improve IVF success rates, especially in couples with repeated implantation failure.The aim of this study was to assess the accuracy of information about ''add-ons'' on the internet, considering the conflicting evidence on their effectiveness. DESIGN: A systematic evaluation of fertility clinics websites. We developed a 10-criteria structured questionnaire to evaluate the quality of information on endometrial scratching, assisted hatching, intralipids infusion and PGT-A, available through the internet.MATERIALS AND METHODS: The search and review were performed in January-February 2020 by a single investigator. We included English language websites that presented in the Google.com search engine after typing the following key words: ''endometrial scratching'' (ES), ''intralipid infusions'' (ILI), ''assisted hatching'' (AHA), ''PGT-A'' or "PGS''. As the previously used term ''PGS'' is often still used instead of PGT-A, we searched for both words.RESULTS: 260 unique websites were evaluated. For the procedures listed, almost all the websites belonged to private clinics. Only for AHA (3 clinics), and PGT-A (2 clinics), we also found public institutions that provided information. An accurate description of the ''add-on'' procedures was provided in most cases (78.8%). However, only a minority (12%) of these websites reported on the inconclusive effectiveness of these procedures. The use of PGT-A was most often encouraged (52.8%), compared to ES (23.6%) and AHA (16%). The additional cost of the ''add-on'' procedure was rarely presented (6.9%). Literature references were never provided for ILI and only rarely, 12.7%, for ES, 4.0% for AHA and 5.6% for PGT-A. Date of entry of the information was frequently not reported. None of the websites reported the clinic's pregnancy rates following of the ''add-on'' procedures.CONCLUSIONS: The information about ''add-ons'' available to the public from IVF clinics' websites is often inaccurate. This could perpetuate false myths among patients about the effectiveness of these add-on procedures and raises concern regarding possible commercial bias. It is imperative that IVF clinics' websites better communicate the associated risks and uncertainties of "add-on'' procedures to prospective patients.