1 July 2021: Although there is limited evidence to suggest that fertility add-ons can increase the chances of having a child, 82% of IVF patients have used at least one of these methods.This conclusion is based on a retrospective study that included 1,590 Australian patients. It also revealed that more than 72% of those surveyed had paid additional for unproven therapies and techniques, which include Chinese herbal medicine and endometrial shaving.Principal investigator Dr Sarah Lensen from the University of Melbourne will present the results of an online survey on the prevalence of these optional additionals today at the 37th virtual Annual meeting of ESHRE.Lensen says that the findings suggest that patients may not have been adequately informed about the insufficient evidence supporting "the safety and effectiveness of add-ons". Lensen says that patients need to be provided with transparent and easily accessible information, as well as large randomised controlled trials of high quality. This will help them make informed decisions and minimize the feeling of regret for having failed IVF.This report on add-ons was based on a questionnaire that Facebook advertised and which was completed by IVF patients between June 2020 and July 2020. Patients who had surrogates for gestation or who were pregnant were not included, as were patients who were able to donate eggs or who underwent elective egg freezing.Participants were asked questions about their IVF history and about any add-ons they used over the past 3.5 year, including details about specific treatments and costs. Participants were also asked about their opinions on safety and effectiveness.The results also revealed that acupuncture was the most popular add-on, followed by preimplantation gene testing for aneuploidy(PGT-A) (28%), and Chinese herbal medicine (26%).Lensen says that add-ons such as heparin and aspirin are likely to have negligible costs. She points out, however, that PGT-A or repeated add-ons over multiple cycles will likely result in significant expenses.A relatively small number (18%) of women who use add-on fertility treatment reported that they raised the matter first. More than half (54%) said they were first told about them by their fertility specialist. 71 percent of respondents said that their specialist usually discussed add-on options in consultations.The study also revealed that women place a lot of importance on scientific evidence supporting add-ons. Over half of the respondents (55%) gave a score above 90 out of 100 indicating that they believe it is important that there is evidence that addons can improve live birth rates. 73% also believed that their safe use was equally important. Lensen says this despite the fact that there are many associations against it. Many add-ons do not have evidence to increase live birth rates (LBRs). Some, such as immune therapies, have been associated with low birth weights and other problems.A third (30%) of women regretted adding ons to their lives, compared to 34% who did not regret using them. Women who did not have a live birth or conceive had more regrets. Additionally, women who said that their fertility specialist had had more than half an impact on their decision to use an addon were more likely to regret it than those whose doctor played a smaller role.These study results are coming at a time when other treatments are being scrutinized more closely. The Human Fertilization and Embryology Authority (HFEA), a UK regulator, has established a traffic light system to assess add-ons. However, none have been given a green light.Lensen says that some adjunct therapies may be associated with significant financial burdens and could even pose a risk to patients. Lensen believes that impartial, evidence-based information such as the HFEA should be made available in other countries.###Presentation 0-215, Thursday, 1 July 2021What is the prevalence of add-ons and how can patients make a decision about whether or not to use them? An international survey of IVF patientsFertility add-ons: Uptake and Concerns1. According to a survey conducted by HFEA, 74% of patients who visited fertility clinics in 2017 or 2018 used add-ons.2. These figures could be higher in countries like the USA, Switzerland, or Australia, where IVF is mostly privately funded.2. ESHRE has supported the HFEA consensus statement. This calls for higher-quality research and follow up of patients. It also convened an expert panel on responsible use of add-ons.* Journalists are asked to inform their contacts about the embargo when obtaining outside commentary.
