10 August 2019 | New Scientist | 23T
HE man’s crotch, covered
only by his underpants,
was level with my head and
twice as large as life. Luckily it was
only a poster at a trade exhibition
for fertility doctors I attended
in Vienna. It was advertising
supplements claimed to boost
sperm counts. Odd, given that
a recent review concluded that
the evidence for the effectiveness
of such pills is inconclusive.
It was the first time I had been
to this conference, the annual
meeting of the European Society
of Human Reproduction and
Embryology. I was both awed
and appalled by what I heard.
For all the good that reproductive
JOSIE FORDtechnologies do, for all the joy they
Comment
Clare Wilson is a medicine
and health reporter for
New Scientist. Follow her
on Twitter @ClareWilsonMedViews
The columnist
Chanda Prescod-
Weinstein on
red dwarfs p24Letters
Embed data ethics
into health DNA
projects p26Aperture
Releasing gorillas
into the forests of
Gabon p28Culture
The call of the moon
at a new London
exhibition p30Culture columnist
Simon Ings on
electrifying the US in
the 19th century p32bring to those who otherwise may
have been unwillingly childless,
the whole field is also riddled with
pseudoscience.
Since the birth of the first IVF
baby, Louise Brown, 41 years ago,
more than 8 million babies have
been born after being conceived
this way. But many people who
have IVF don’t end up with a baby
in their arms. Success varies with
age, but overall just one in four IVF
cycles leads to pregnancy. In the
UK and many other countries,
couples often have to pay for IVF,
as it is seen as optional rather than
a life-saving medical treatment.
With some able to afford just one
or two attempts, there is inevitably
a lot of disappointment.To try to boost pregnancy rates,
many clinics offer other options
as well as the basic IVF procedure.
Sometimes called “add-ons”, these
usually add on to the price too.
Many were developed on theory
alone, without clinical trials to
test they truly work.
Last year, the UK regulator,
the Human Fertilisation and
Embryology Authority, developed
a traffic light system for IVF add-
ons, giving a red if there is no
evidence of an improved chance of
conceiving, amber if there is little
or conflicting evidence and green
if the evidence suggests they could
be used routinely. Of the 11 add-ons
it has reviewed, none get a green.
Some of these procedures arenow belatedly going through
trials. During the conference,
researchers announced trial
results showing that two widely
used add-ons gave no benefit
for most couples. One is freezing
the embryos for a month or two
before putting them in the uterus.
The other is a technique called
ICSI, which involves a sperm being
injected into an egg. ICSI was
developed to help couples where
the man’s sperm cannot swim, but
is now offered to anyone. Cycles
done this way outnumber those
of regular IVF by three to one.
When I spoke to attendees at
the conference, several agreed
that things are bad. Some were
insistent their clinic didn’t carry
out such practices unnecessarily.
Others justified offering these
procedures by saying couples
are asking for them.
That isn’t good enough. Doctors
can always refuse any treatment
they feel isn’t in someone’s best
interests. If there is no good
evidence that a procedure boosts
pregnancy rates, it shouldn’t be
offered commercially. Those
clinicians who are genuinely
researching new procedures
should carry them out only as part
of trials where they are provided
free of charge, as in most other
areas of medicine. Anything else
risks exploiting the desperate and
the vulnerable. ❚Cease the IVF racket
Fertility clinics must stop profiting from expensive,
unproven add-on treatments, says Clare Wilson