A growing number of in vitro fertilization (IVF) add-on treatments, often marketed to increase the chances of conception, are not supported by reliable scientific evidence and may even be detrimental to a woman's health, according to a recent review. The study, published in The Lancet Obstetrics, Gynaecology & Women’s Health journal, found that over 70% of IVF patients now opt for these additional procedures, which typically range from £150 to £3,000 each.
Natasha Whiting, a 39-year-old who has undergone three failed IVF attempts, spent approximately £10,000 on various add-on treatments, including uterine microbiome analysis and extensive blood tests, in addition to the £60,000 spent on IVF cycles over four years. Despite the assurances from her private London fertility clinic, her tests revealed no underlying issues that would explain her infertility.
Researchers concluded that most add-ons do not improve conception rates and could potentially hinder fertility and harm women's health. Dr. Sarah Lensen, a senior research fellow at the University of Melbourne and study author, noted that these unproven treatments can lead to "false hope, greater financial strain and unnecessary medical procedures at what already can be a very difficult time."
Unlike medications, many IVF add-ons are not classified as drugs, bypassing the rigorous clinical trials required to prove their efficacy and safety. Dr. Ippokratis Sarris, a consultant in reproductive medicine at King's College Hospital in London, described them as "products, out on the market with a small amount of data." He added that while some practitioners may genuinely believe they are helping patients, "belief is not the same as fact." Some treatments, like platelet-rich plasma ovarian injections, have been associated with risks including bleeding, infection, and ovarian scarring, without proven benefits.
The global IVF market is estimated to be worth £18 billion annually, with add-on treatments contributing a significant portion. Critics refer to these as a "tax on hope," preying on the vulnerability and desperation of women seeking to conceive.
While the Human Fertilisation and Embryology Authority (HFEA) in the UK has requested further government oversight, current regulations limit its ability to prevent clinics from offering these procedures. Professor Tim Child, of the University of Oxford and a member of the HFEA board reviewing add-ons, stated, "The difficulty is the HFEA has no authority to prevent clinics offering add-ons." He described the situation as a "minefield" and highlighted the need for more powers and better quality studies.
Social media platforms also play a role, with unverified success stories on sites like TikTok sometimes being perceived as definitive proof of a treatment's effectiveness. Dr. Sarris noted that he often spends consultations advising patients against certain procedures, yet they still insist on trying them.
Women may feel pressured to pursue every possible option, driven by a sense of guilt if they don't. Natasha herself admitted, "I think I am reasonably intelligent. My attitude is, maybe they don’t work, but even though there’s limited proof, I want to look back and say I’ve done everything possible." She also acknowledged following IVF doctors on Instagram and considering that sufficient evidence.
Natasha's journey involved multiple procedures, including a hysteroscopy and an EMMA test to analyze the uterine microbiome, the latter being graded 'grey' by the HFEA due to insufficient evidence. She also underwent Preimplantation Genetic Testing for Aneuploidy (PGT-A) on nine embryos, five of which were deemed non-viable. While PGT-A is graded 'green' for reducing miscarriage risk in most women, the HFEA notes insufficient evidence for older women and states it does not increase live birth rates.
Her first embryo transfer included EmbryoGlue, an add-on graded 'amber' by the HFEA, meaning its effectiveness is unclear. Professor Child pointed out that a significant portion of research used in evaluating add-ons has been excluded due to methodological flaws or concerns about data integrity, with some studies even being retracted.
Following her third failed attempt, which left her feeling certain she was pregnant, Natasha explored further diagnostic options, including an ALICE test, which also assesses bacteria in the uterine lining. Despite these efforts, and all her blood tests coming back clear, she and her partner remain at a loss about their next steps. She is now considering a drug to minimize inflammation caused by her endometriosis before deciding on another egg retrieval or transferring one of their two remaining embryos.
"We're not ready to give up yet," she stated, indicating that any further steps will involve additional costs. For individuals like Natasha, the cycle of testing, trying, and hoping continues, with the constant temptation of new add-ons promising a chance at conception.