Couples desperate to have a baby are being hit with bills of close to £8,000 for ‘bolt-on’ IVF treatments they may not need, experts claim.
The cost of IVF can more than triple to include procedures claimed to have little or no supporting evidence, or which benefit only some women.
A retired fertility consultant described selling such add-ons as ‘unethical’, and one clinic’s medical director – who has published a paper on the issue – said more regulation was urgently needed.
The £7,870 bill is based on charges at London’s biggest clinics for eight treatments claimed to be unsuitable or lacking evidence. This is on top of a standard round of IVF, which can cost about £3,500.
Professor Geeta Nargund, medical director of Create Fertility clinics, said: ‘We urgently need regulation to stop unnecessary use of drugs and the use of technologies with no proven benefit.
‘We need to educate our patients about this, but many would still accept additional cost and unnecessary treatments despite advice to the contrary because they are willing to try anything in the hope it will increase their success rate. This is tragic and unacceptable.’
The eight treatments outlined in her paper include an ‘endometrial scratch’, which costs £350 at the clinic IVF Hammersmith. It involves gently scratching the womb lining and is believed to help the embryo implant by making a furrow or releasing hormones that make the womb more adhesive.
However, a review of four trials found that although the process improved the number of babies born to women with two or more previous failed implants, it was of no benefit to those with just one or no failed IVF cycles.
Assisted hatching, based on the principle that older women produce harder shells for an embryo to ‘hatch’ from, sees chemicals or a laser used to soften the layer. Earlier this month, Dr John Parsons – a former King’s College Hospital consultant who worked on the first IVF births – described the procedure, which costs £615 at London’s Lister Clinic, as a ‘nice little earner’. Researchers found some evidence it can increase pregnancies in women who have been unsuccessful before, but none in older women or those with a good prognosis.
Professor Nargund argues that until it is proven to boost birth rates, it should not be offered.
Time-lapse monitoring of embryos, charged at £775 by CARE clinic, has no good quality evidence to routinely recommend it, according to the paper published last year.
An intra-cytoplasmic morphological sperm injection – £600 at the Centre for Reproductive and Genetic Health – examines sperm under a powerful microscope to find defects before it is injected directly into an egg. It leads to no more pregnancies than a basic sperm injection, analysis of previous trials found.
Other contested add-ons include immune tests, £720 each at the London Women’s Clinic, and genetic screening – £3,100 at the Lister or the London Women’s Clinic.
Dr Parsons said: ‘It’s a terrible shame so much commercialisation is occurring. To offer things … the effectiveness of which has not been substantiated, is unethical.’
Professor Geeta Nargund, medical director of Create Fertility clinics, said: ‘We urgently need regulation to stop unnecessary use of drugs and the use of technologies with no proven benefit (file pic)
The five clinics from which prices were taken have the highest number of patients according to the latest figures from the Human Fertilisation and Embryology Authority, up to June 2014.
Create’s price list included add-ons but it claims to try to dissuade couples from buying unnecessary ones. A CARE spokesman said: ‘We are confident that in our hands any additional IVF procedure we offer is always for the patient’s benefit.’
Lister’s James Nicopoullos said his clinic uses assisted hatching only in rare cases and that ‘absence of evidence of benefit doesn’t always necessarily mean there is evidence of an absence of benefit’.
Stuart Lavery of IVF Hammersmith said it ensures patients can make ‘fully informed decisions …[and] guidance is given with their best interests at heart, including the acknowledgement of uncertainty’.
Dr Kamal Ahuja of the London Women’s Clinic said: ‘Add-ons when clinically justified or clearly explained in advance, coupled with the availability of counselling, allow us to offer a fair and transparent service.’
CRGH’s Paul Serhal said: ‘It is very important to make the evidence absolutely clear and I insist to all patients at consultation that IVF is not evidence-based.’
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