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. 2016 Nov 27;6(11):e013940.
doi: 10.1136/bmjopen-2016-013940.

Claims for fertility interventions: a systematic assessment of statements on UK fertility centre websites

E A Spencer  1 , K R Mahtani  1 , B Goldacre  1 , C Heneghan  1
Affiliations

Claims for fertility interventions: a systematic assessment of statements on UK fertility centre websites

E A Spencer et al. BMJ Open. .

Abstract

Objectives: Fertility services in the UK are offered by over 200 Human Fertilisation and Embryology Authority (HFEA)-registered NHS and private clinics. While in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) form part of the National Institute for Health and Care Excellence (NICE) guidance, many further interventions are offered. We aimed to record claims of benefit for interventions offered by fertility centres via information on the centres' websites and record what evidence was cited for these claims.

Methods: We obtained from HFEA a list of all UK centres providing fertility treatments and examined their websites. We listed fertility interventions offered in addition to standard IVF and ICSI and recorded statements about interventions that claimed or implied improvements in fertility in healthy women. We recorded which claims were quantified, and the evidence cited in support of the claims. Two reviewers extracted data from websites. We accessed websites from 21 December 2015 to 31 March 2016.

Results: We found 233 websites for HFEA-registered fertility treatment centres, of which 152 (65%) were excluded as duplicates or satellite centres, 2 were andrology clinics and 5 were unavailable or under construction websites. In total, 74 fertility centre websites, incorporating 1401 web pages, were examined for claims. We found 276 claims of benefit relating to 41 different fertility interventions made by 60 of the 74 centres (median 3 per website; range 0 to 10). Quantification was given for 79 (29%) of the claims. 16 published references were cited 21 times on 13 of the 74 websites.

Conclusions: Many fertility centres in the UK offer a range of treatments in addition to standard IVF procedures, and for many of these interventions claims of benefit are made. In most cases, the claims are not quantified and evidence is not cited to support the claims. There is a need for more information on interventions to be made available by fertility centres, to support well-informed treatment decisions.

Keywords: evidence-based medicine; fertility; patient information.

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Conflict of interest statement

EAS has no competing interests. CH has received expenses from the WHO and holds grant funding from the NIHR, the NIHR School of Primary Care Research and the WHO. BG has received research funding from the Wellcome Trust, the NIHR School of Primary Care Research, the Laura and John Arnold Foundation, NHS England and the Health Foundation; he receives personal income from speaking and writing for lay audiences on problems in science.

Figures

Figure 1
Figure 1
Flow chart of websites included in the analysis.
Figure 2
Figure 2
Number of claim statements found on 74 fertility treatment websites, by intervention offered (total claims=276).
See this image and copyright information in PMC

References

    1. NICE National Institute for Health and Care Excellence. http://cks.nice.org.uk/infertility#!topicsummary. Clinical knowledge summaries. Infertility (last revised April 2013).
    1. NICE guidelines [CG156] fertility problems: assessment and treatment. Published date: February 2013. Last updated: August 2016. 1.2 Initial advice to people concerned about delays in conception. https://www.nice.org.uk/guidance/cg156/chapter/Recommendations#initial-a... (accessed 18 Aug 2016).
    1. NICE guidelines [CG156] Fertility problems: assessment and treatment. 2013 1.11 Access criteria for IVF. 1.11.1 Criteria for referral for IVF 1.11.1.3 [new 2013]. https://www.nice.org.uk/guidance/cg156/chapter/Recommendations#initial-a... (accessed 18 August 2016).
    1. Human Fertilisation and Embryology Authority (HFEA). http://www.hfea.gov.uk/ (accessed 18 Aug 2016).
    1. Some clinics using techniques not stringently tested. The great IVF rip-off. Daily Mail. http://www.dailymail.co.uk/health/article-3592661/The-great-IVF-rip-Clin... (accessed 18 Aug 2016).

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