Is the use of IVF add-on treatments driven by patients or clinics? Findings from a UK patient survey

Abstract

There are conflicting narratives over what drives demand for add-ons. We undertook an online survey of IVF patients to determine whether patients perceive that use of IVF add-ons is driven by patients or practitioners. People who underwent IVF in the UK in the previous five years were recruited via social media Survey questions focussed on the roles of clinician offer and patient request, including who first suggested use of add-ons in IVF consultations, where patients first heard about them, and which information sources they trusted. From a total of 261 responses, 224 met the inclusion criteria. Overall, 67% of respondents had used one or more IVF add-ons, most commonly: time-lapse imaging (27%), EmbryoGlue (27%), and endometrial scratching (26%). Overall, 81% of the add-ons used were offered to participants by clinicians (compared to 19% requested by themselves). Half (54%) reported being offered add-ons during consultations, compared to 24% who initiated discussion about add-ons. Higher proportions of private patients reported being offered (90%), requesting (47%) and using (74%) add-ons than those with NHS funding (74%, 29%, 52%, respectively). The main limitations of this study are the small sample size, recruitment via a convenience sample, and the self-reported data capture which is subject to recall bias.

Keywords:

• Survey
• add-on
• endometrial scratch
• embryoglue
• IVF
• assisted conception

Acknowledgements

The authors thank the patients who provided feedback on the study design and all patients who completed the survey.

Author contributions

SC conceived the idea for the study, designed and carried out the survey, and prepared the first draft of the paper. JCF contributed to study objectives and survey design. JW performed the data analysis. SL contributed to the data analysis and preparation of the manuscript. All authors contributed to interpretation of the data, manuscript preparation, and approved the final version.

Disclosure statement

EJ and JCF declare no conflicts of interest. SC was employed via an agency contract by the HFEA whilst designing and conducting the study. JH was a member of the HFEA Scientific and Clinical Advances Advisory Committee (SCAAC) who developed the HFEA traffic lights system. SL, JW, JH, and KL declare research and personal (KL) interests in IVF add-ons, and have published extensively on IVF add-ons and their evidence base.

Data availability statement

The data is available upon reasonable request to the corresponding author.

Additional information

Funding

No specific funding was obtained for this study.