The prevalence, promotion and pricing of three IVF add-ons on fertility clinic websites

Abstract

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.

The crafting of hope: Contextualising add-ons in the treatment trajectories of IVF patients

“…Scholars suggest that the commercialisation of add-ons is part of a wider speculative turn in IVF, with the sector attracting an increasing amount of venture capital and private equity investment ( Van de Wiel, 2019 , 2020 , 2020 ). Studies reviewing how add-ons are offered by British IVF clinics ( Spencer et al, 2016 ; Van de Wiel et al, 2020 ) criticise the lack of clarity regarding their safety and effectiveness. For these reasons, some IVF professionals are critical toward the uncontrolled spread of add-ons ( Rutherford, 2017 ; Repping, 2019 ) and advocate caution in offering potentially non-beneficial add-ons to vulnerable patients without solid evidence ( Harper et al, 2017 ).…”

Analysis of fertility clinic marketing of complementary therapy add-ons

“…Although this study found that clinics advertising complementary therapies were in the minority, and complementary therapies were not offered at the same level as laboratory or clinical add-ons ( van de Wiel et al, 2020 ), the HFEA patient survey found that a significant proportion of patients incorporate complementary therapies into their IVF journey ( HFEA, 2018 ). There are two possible reasons for this observed discrepancy.…”

“…An in-vitro fertilization (IVF) add-on is defined as any technique that is a variation of, or add-on to, the ‘normal’ IVF cycle. This includes laboratory, clinical and complementary treatments ( van de Wiel et al, 2020 ). With increasing demand for IVF, and competition between clinics to attract patients, it is unsurprising that a number of treatment add-ons are marketed to patients ( Harper et al, 2017 ).…”

Sperm Selection by Magnetic-Activated Cell Sorting before Microinjection of Autologous Oocytes Increases Cumulative Live Birth Rates with Limited Clinical Impact: A Retrospective Study in Unselected Males

“…Patients and clinicians tend to be willing to try diverse add-ons after several attempts have failed. However, their added costs should not be dismissed if their use is not justified by a proven increase in possibility to achieve a successful pregnancy [ 31 , 32 ]. Bearing in mind the controversy around the introduction of add-ons into the clinical practice without proper security and regulatory reviews [ 33 , 34 ], it is of utmost importance that clinicians are provided with reliable information resulting from carefully designed research, both prospective (randomized clinical trials or RCTs) and retrospective, making use of powerful statistical tools, proper designs, and bias control [ 35 ], to ensure that patients receive treatments catered to their needs and situation.…”