The majority of women undergoing in vitro fertilization (IVF) are opting to pay for add-ons treatments despite limited evidence surrounding their effectiveness.
Research presented last week at the annual meeting of the European Society of Human Reproduction and Embryology reported that 82 percent of the women in the study used IVF add-ons.
The study focused on a cohort of Australian women, but the researchers say the number of women using IVF add-ons could be even higher in countries such as the United States where IVF is often privately funded.
“It has been suggested that IVF add-on use might be more common in areas where IVF is largely provided by private companies rather than through public clinics. In Australia, IVF is largely provided by private companies and this is similar to the situation in the U.S. So, it is likely that IVF add-on use may be widespread in the U.S., too,” Sarah Lensen, PhD, lead author of the research and a research fellow at the National Health and Medical Research Council in Australia, told Healthline.
There is no established, clear definition for IVF add-ons, but generally they are considered procedures, techniques, or medicines that can be used in addition to standard IVF procedures with the goal of improving the likelihood of a successful conception and birth.
IVF add-ons may include acupuncture, pre-implantation genetic testing for aneuploidy, Chinese herbal medicine, endometrial scratching, growth hormones, assisted hatching, aspiring, melatonin, and prednisolone.
Many of these IVF add-ons are commonly used in the United States.
“Pre-implantation genetic testing for aneuploidy is increasingly used in the U.S. as is the endometrial receptivity array (ERA), assisted hatching, growth hormone, and time-lapse imaging of embryos,” Dr. Molly Quinn, an assistant clinical professor of obstetrics and gynecology in the division of reproductive endocrinology and infertility at the David Geffen School of Medicine at the University of California Los Angeles, told Healthline.
“In general the idea behind many of the add-ons is that their use is unlikely to be harmful and may prove to be beneficial. This may be true of acupuncture, for example. However, many of the laboratory techniques described have yet to have high level safety data,” she noted.
The researchers found that 72 percent of the women surveyed had incurred additional costs from IVF add-ons, despite a lack of evidence supporting the efficacy of the additional treatments.
“IVF add-ons are not considered to be necessary for achieving pregnancy or live birth through IVF. They are ‘optional extras,’” Dr. Lensen said. “There is some moderate or poor-quality evidence supporting some add-ons. However, most are not supported by even this level of evidence and none are supported by high-quality evidence.”
She argues that those undertaking IVF may feel like they have no other option than to try add-on treatments.
“Desperation may well play a part. We know that many people having IVF are desperate. They will do almost anything that might help them to conceive, including opting for unproven or experimental treatments, such as IVF add-ons,” Lensen said.
Quinn added this is a major concern in the United States where coverage for fertility treatments such as IVF is limited in most states.
“Some patients have funds for a single attempt. Patients also have often arrived at years of unsuccessful attempts to conceive naturally or with less aggressive interventions before arriving at IVF. This does create a vulnerable patient population,” she explained.
“IVF is a significant financial commitment for most,” Quinn added. “Everyone is trying to maximize their chance for success… Patients may come to the clinic and ask providers if there is anything else that may be helpful. I suspect that in some scenarios this is where the conversation shifts to discussion of add-ons.”
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