Dr Jyoti Taneja
Consultant Reproductive Medicine & Gynaecology
IVF itself was not subject to randomised controlled trials when it was first introduced into medical practice, and the pioneers of IVF had to refine the techniques with little evidence or support from medical research.
Fertility treatment ‘add-ons’ are procedures and treatments offered alongside IVF – at additional expense to the patient – which may not be supported by robust evidence as it is not currently available. The benefits and appropriateness of add-ons are open to question, and the role of add-ons in fertility treatment has become a matter of heated debate among professionals and also can be confusing to patients. This is also partly because we still don’t have many answers in fertility due to insufficient evidence or research studies. Does equipping the patient with understanding on available evidence or the lack of research effectively amount to a recommendation for or against each add-on? How much evidence is reasonable to expect, before a treatment is offered to patients? If a patient is informed of the lack of evidence for a treatment, and is still prepared to use it, should they be able to do so?
In the UK, Human Fertilisation and Embryology Authority (HFEA), the regulatory authority for fertility treatments, has information about add-ons including those which having growing evidence to support and those that require further research. HFEA’s 2017-2020 Strategy includes the objective to ‘publish clear information so that patients understand treatments and treatment add-ons and feel prepared’.
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