Fertility clinics must stop unproven treatments, watchdog warns

Fertility Clinics Urged to Halt Unproven Treatments: Watchdog Issues Stern Warning

London, UK – A powerful warning has been issued by a leading fertility watchdog, urging clinics across the UK to cease offering a range of popular but scientifically unproven treatments to desperate patients. Draft guidance released by the National Institute for Health and Care Excellence (NICE) targets numerous "add-on" therapies, which, despite widespread use, lack robust evidence of their effectiveness in improving pregnancy rates.

The move, welcomed by patient advocacy groups and fertility experts alike, signals a significant shift in how these often costly and emotionally draining procedures are regulated. For years, many clinics have offered these supplementary treatments as a way to potentially boost success rates, often at considerable extra expense to patients already undergoing financially and emotionally taxing IVF cycles. Now, NICE’s draft guidance aims to bring clarity and evidence-based practice to the forefront.

What Are These Unproven Treatments? The Rise of Fertility Add-Ons

The term "add-ons" refers to a variety of procedures and substances offered alongside standard In Vitro Fertilisation (IVF) treatment. These can include everything from specialized embryo culturing media and genetic testing of embryos (Preimplantation Genetic Testing - PGT) to endometrial scratching and even acupuncture. While some of these interventions have preliminary research suggesting potential benefits, the overarching concern highlighted by NICE is the lack of definitive, large-scale studies proving their efficacy in increasing the chances of a successful pregnancy and live birth.

Consider, for instance, the widespread offering of endometrial scratching. The theory is that deliberately creating a small injury to the uterine lining could stimulate healing mechanisms that make it more receptive to embryo implantation. While some studies have shown a positive association, others have found no benefit, and a significant Cochrane review concluded that the evidence was insufficient to recommend its routine use. Yet, many clinics continue to offer it, often as a straightforward addition to an IVF package.

Similarly, various forms of embryo glue, nutrient supplements for embryos, and even specialized incubators are marketed with the promise of improving outcomes. The problem, as NICE points out, is that the evidence supporting these claims often comes from small, poorly designed studies, or from industry-funded research where bias is a potential concern. This leaves patients in a difficult position, facing significant financial outlays for treatments that may offer little to no tangible benefit.

The Ethical and Financial Burden on Patients

For couples and individuals struggling with infertility, the IVF journey is often fraught with anxiety, hope, and substantial financial investment. The average cost of a single IVF cycle in the UK can be thousands of pounds, and the prospect of increased success rates, however slim the evidence, can be incredibly tempting. This is where the add-ons come into play, often adding hundreds or even thousands of pounds to the overall cost.

“Patients are vulnerable, and they want to do everything they can to have a baby,” said Professor Geeta Nargund, a consultant gynaecologist and Chair of the NICE guideline committee. “But they need to be offered treatments that are proven to work. We have a duty to ensure that patients are not spending money on treatments that have not been rigorously tested and shown to be effective.”

The draft guidance specifically calls for a halt to the offering of treatments where there is no robust scientific evidence of benefit. This includes a range of popular add-ons, such as certain types of assisted hatching, endometrial scratching, and culturing embryos in specific types of media. The message from NICE is clear: the era of offering treatments based on anecdotal evidence or preliminary findings needs to end.

What Does the Guidance Mean for Clinics and Patients?

The implications of NICE’s draft guidance are far-reaching. Fertility clinics will need to re-evaluate their service offerings and ensure that any treatments they provide are supported by strong scientific evidence. This could lead to a significant reduction in the number of add-on treatments available, potentially streamlining IVF processes and, crucially, reducing costs for patients.

For patients, the guidance offers a much-needed layer of protection. It empowers them to ask critical questions about the evidence behind any recommended add-on treatment and to make informed decisions based on scientific facts, rather than marketing claims or the desperation to conceive. It’s about shifting the focus from ‘hope’ to ‘evidence’ when it comes to fertility treatments.

Dr. Adam Balen, Chair of the British Fertility Society, commented on the draft, stating, “This guidance is a vital step forward in ensuring that patients undergoing fertility treatment receive the best possible care, based on robust scientific evidence. It will help to protect patients from unnecessary costs and potentially ineffective treatments.”

The guidance is currently out for public consultation, meaning that clinics, patient groups, and the wider public have the opportunity to provide feedback before it is finalized. This collaborative approach is crucial in ensuring that the final recommendations are practical, effective, and widely accepted.

The Path Towards Evidence-Based Fertility Care

The move by NICE is part of a broader global trend towards greater scrutiny and regulation of fertility treatments. As IVF becomes more common, so too does the array of associated services and technologies. Without clear guidelines and a commitment to evidence-based practice, there is a risk that the fertility industry could become a minefield of unproven and expensive interventions.

The draft guidance emphasizes the importance of shared decision-making between patients and clinicians. It encourages open conversations about the risks, benefits, and costs of all treatment options, ensuring that patients are fully informed and empowered. This is not about denying patients hope, but about grounding that hope in scientific reality.

While the finalized guidance is still some months away, the message from NICE is unequivocal: it’s time to stop offering unproven fertility treatments. This is a significant development that promises to bring greater transparency, affordability, and, most importantly, effectiveness to the complex and deeply personal journey of building a family through assisted reproduction. The future of fertility care, it seems, is firmly rooted in evidence.