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IVF “add-ons” – are they worth the money?”

Michael Gorton AM

IVF treatments in Australia are already expensive with a cycle costing up to $10,000 per cycle. There is no guarantee that a cycle will result in a successful pregnancy and some couples may need several cycles before achieving a pregnancy.

In the landmark “Gorton Review” of Assisted Reproductive Treatment by Russell Kennedy Principal, Michael Gorton, AM (Final Report of the Independent Review of Assisted Reproductive Treatment – May 2019), it was noted:

“Many people seeking ART services have already experienced distress arising from infertility and almost all prospective parents come with a high emotional (as well as financial) investment in the treatment. This can leave people vulnerable to pressure to commence or continue with the treatments that may have very limited prospect of success. It can also lead patients themselves to push for additional services and treatments, even where there is little evidence of their efficacy and/or safety, and may in fact be harmful.”

Recent research also suggests that some “add-on” treatments offered in conjunction with IVF treatment have little or no evidence to support them. Sometimes the “success rates” associated with add-on treatments can be overstated.

Recent research (‘How common is add-on use and how to patients decide whether to use them? A national survey of IVF patients’ – Human Reproduction 2021) found that 82% of the 1,590 women surveyed had been offered and used an add-on treatment whilst undergoing IVF. Some of the most common add-on treatments included acupuncture, pre-implantation genetic testing of embryos and even Chinese herbal medicine. The researchers identified that the evidence base for some additional treatments was low.

Given that the add-on treatments can come with additional substantial cost to couples, the research raises the question as to whether further regulation or legal remedies should be available in circumstances where the success of treatments are overstated or whether the treatment in fact has little to no benefit at all.

The Gorton Review recommended regulatory changes to provide a framework to support improved quality, safety, experience and outcomes for individuals, and provide clarity to couples about their rights.

The Victorian Assisted Reproductive Treatment Authority also has information available through its website to advise prospective couples on questions to ask about IVF add-ons and to assist couples to be more fully informed. Couples are encouraged to ask:

  • Do I really need this test, treatment or procedure?
  • What are the risks?
  • Are there similar, safer options?
  • What happens if I don’t do anything?
  • What are the costs?

Also following a review by the Victorian Health Complaints Commissioner, the Commissioner indicated that there was a need for assisted reproductive treatment providers to get written, informed consent from couples before the use of each add-on treatment. The informed consent would include information in relation to success rates, as well as costs.

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