In Defence of 'Add-Ons'

There have been a couple of articles recently about the HFEA's decision to curtail 'expensive add-ons'.

This is not an IVF consultant!

This is not an IVF consultant!

We do admire what the HFEA are trying to do.  They are safeguarding the patient from being exploited which is vital, but we are very much on the side of the patient having a choice.  Not all procedures have strong evidence, yet, for altering success rates but that doesn't mean they don't or won't work and (as long as they do no harm)  the more we learn the better for everyone.  Our patients are generally very well informed and not easily led.  They've done their research and they know what they want.   We don't see that taking choice away from them will make their paths any easier.

Not only that, but the Press paints an incorrect picture of innocent and ignorant couples being led down dark alleys by unscrupulous Mr Burns-type private consultants who are only after money.  This is not at all accurate on two fronts. 

First it assumes that couples can't make their own wise decisions.  That's not what we see in real life.

Secondly it makes out all private fertility consultants to be profit orientated manipulators which is also incorrect. The consultants we work with in Edinburgh and Glasgow will only offer patients what they really think might help them and are careful with procedures that have limited testing or marginal effects on success rates.  

Often consultants have to work hard to guide couples away from unnecessary testing or procedures which have no proven impact.  They have to carefully tread a path between the often desperate needs of patients vs the limited scientific evidence for various procedures.  They have to decide whether or not to support a patient who wants to try something new and is well-informed about the potential outcomes, in the knowledge that a determined patient will often seek these procedures or tests somewhere else.  

After all, we certainly don't know everything about fertility and we probably never will.  Drugs that are 'guaranteed' to stimulate follicles sometimes aren't effective; endometrial lining doesn't always respond to hormonal input - we are not robots after all - so if something has no or minimal side-effects and may have a positive impact then why not try it?

Our bone of contention with private or self-funded IVF clinics is how quickly couples are referred for IVF.  We often see patients who have irregular cycles and are missing their fertile window, with low semen analysis results or with undiagnosed hypothyroid, endometriosis or PCOS.  All of these have a negative impact on fertility and should be rectified before going down the route of IVF.

We applaud patients who take their fertility health into their own hands.  Couples should be encouraged to investigate options and make solid, results-based decisions on where to go for treatment and what treatments to ask for and the consultants as well as experienced and well-informed health practitioners like ourselves should be on hand to guide and  support them in these choices.