The use of add-on treatments as part of an IVF cycle in the UK has generated much debate amongst professionals in the field.
Add-on’s are optional extras which can complement an IVF cycle, although many lack solid evidence to support their benefit. They are generally also provided to the patient at an extra cost.
The ‘gold standard’ proof of efficacy of a clinical treatment is generally determined by a randomised controlled trial (RCT) confirming a significant benefit of the treatment. Undertaking RCT’s however, can be costly, time consuming and impractical in many cases. Although some add-on treatments may not be backed by RCT’s, in cases of unexplained infertility where an add-on may have some potential benefit, it could be worth trying.
Patient’s may also carry out their own research and wish to try add-on treatments despite the clinic considering them to irrelevant or likely to have little effect on their particular treatment. It may be argued that patient’s should be able to decide whether to have certain add-on’s as part of their treatment, particularly when self-funding. They should, however, be appropriately informed about the evidence for and against the add-on’s effectiveness.
The European Society of Human Reproduction (ESHRE), proposes that add-on’s should not be offered to patients unless proven effective, or at least not at any additional cost. The Human Fertilisation and Embryology Authority (HFEA), currently rates add-on treatments with a traffic light system based on available evidence of their effectiveness. The UK Competition and Markets Authority have also recently released guidance for fertility clinics, outlining their obligations when offering add-on treatments, such as providing information about the available evidence.
Although the advent of new technologies which can possibly benefit patient’s undergoing IVF treatment is a positive step, treatments should be thoroughly researched prior to offering to patients.