IVF success rates ‘misleading’
Success rates advertised on the majority of IVF clinic websites are potentially misleading, because clinics can cherry-pick their results, according to a new study.
Jack Wilkinson, a medical statistician at The University of Manchester, argues an outright advertising ban should be considered if no binding standard of reporting is brought in.
The National Institute for Health Research Doctoral Research Fellow said: “Our study shows that success rates are advertised on 67% of IVF clinic websites, and many of these may be highly misleading, because clinics can cherry-pick their results from a dizzying array of options.
“The concern is that clinics can always construct figures that show their own performance in the best possible light while making competitors look bad.
“This is not helpful to patients, who may struggle to understand differences in what each clinic reports and may be misled into making comparisons on the basis of incomparable results.
“Even if clinics are acting in good faith, the current system does not produce clear or reliable information for the people that need it.
“Just as advertising of prescription drugs to patients is not permitted, a ban on advertising IVF should be considered if there is no binding standard of reporting.”
The research is published in BMJ Open and funded by NIHR and The University of Manchester.
As over half of all IVF in the UK is privately funded, clinics can compete for patients by advertising success rates on their websites.
Although direct-to-consumer advertising of prescription drugs is banned in the UK, there are no such restrictions on IVF.
The study’s lead author, based at the University’s Centre for Biostatistics , added: “IVF is expensive and likely to fail though couples may not get that impression when visiting these IVF clinic websites.
Just as advertising of prescription drugs to patients is not permitted, a ban on advertising IVF should be considered if there is no binding standard of reporting
“There is a strong incentive to selectively report success rates in a way that exaggerates performance. A lack of binding guidance means that clinics are free to do this.”
The research team identified IVF clinic websites using the online registry of the Human Fertilisation and Embryology Authority (HFEA).
Of the 53 clinic websites reporting success rates, out of a total of 79 investigated:
- Pregnancy rates were reported more frequently (83% of these clinics) than birth rates (51%), despite the latter being the item of importance to patients.
- The team found 33 different ways of reporting pregnancy rates and 9 different ways of reporting birth rates. Each of these may be reported for different subgroups of patients and different time periods.
- 72% presented results without specifying the sample size, 26% without giving the ages of patients, and 23% without giving the calendar period.
NOTES FOR EDITORS
Jack Wilkinson is available for interview
Wilkinson J, Vail A, Roberts SA. Direct-to-consumer advertising of success rates for medically assisted reproduction: a review of national clinic websites is published today in in BMJ Open 2016;6:e012218.doi:10.1136/bmjopen-2016-012218. It is available on request
JW is funded by a Doctoral Research Fellowship from the National Institute for Health Research (DRF-2014-07-050). The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.
The University of Manchester, a member of the prestigious Russell Group, is the UK’s largest single-site university with 38,600 students and is consistently ranked among the world’s elite for graduate employability.The University is also one of the country’s major research institutions, rated fifth in the UK in terms of ‘research power’ (REF 2014). World class research is carried out across a diverse range of fields including cancer, advanced materials, addressing global inequalities, energy and industrial biotechnology.No fewer than 25 Nobel laureates have either worked or studied here.It is the only UK university to have social responsibility among its core strategic objectives, with staff and students alike dedicated to making a positive difference in communities around the world.Manchester is ranked 35th in the world in the Academic Ranking of World Universities 2016 and 5th in the UK. The University had an annual income of almost £1 billion in 2015/16.
The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. The NIHR is the research arm of the NHS. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its worldclass infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (www.nihr.ac.uk).