News

GIFT or rip-off?

In vitro fertilisation clinics with poor success rates have come under fire in the fifth annual report of the Interim Licensing Authority (ILA), Britain’s regulatory body on infertility treatments. The ILA has threatened to withdraw licenses from the centres with the worst results.

Figures collected by the ILA show an average “take-home baby rate” of 9.1% in 1988, the latest available year. Some clinics have achieved rates of less than 2% particularly those doing less than 100 treatment cycles per year. The cost of treatment to an individual couple is typically £1,500 - £2,000, regardless of outcome. Some women go through four or more cycles without success.

”We expect centres to come up to 6%”, said Dame Mary Donaldson, chair of the authority, speaking at a press conference to launch the report, “and some do not”.

Professor William Thompson, a Belfast obstetrician and member of the authority, said: “For clinics to charge patients large sums of money for a success rate of 1 or 2% is unethical in my view.

”They are cashing in. They are virtually obtaining money under false pretences.”

Prof Thompson was also concerned that some units are prepared to treat almost anyone, regardless of age or chance of success. He urged clinics to ensure adequate and impartial counselling for couples, to identify early those who were unlikely to benefit from available techniques.

”Far too often patients travel around from one clinic to another undergoing repeated, costly treatment. Five years later the unfortunate couple, who have predictably remained childless, have missed the boat for adoption”, he said.

There has been a rapid growth in the number of centres offering IVF and GIFT in the last year — though there remains only one wholly NHS funded unit. The GIFT technique involves laboratory collection of sperm and eggs, but allowing fertilisation to occur in the womb. Currently there are 45 centres offering GIFT along, but since the ILA’s remit covers only IVF, these are subject to no regulation at all.

The authority is concerned that some of the new GIFT clinics “have been seeking to establish themselves without adequate facilities or appropriately trained staff”.

The ILA has also tackled the difficult issue of the shortage of human eggs. Potential donors are women undergoing sterilisation. Doctors involved in fertility treatment and research are overwhelmingly in favour of some form of encouragement to such women to donate their eggs — such as sterilisation in a private hospital, or moving to the front of the NHS queue for the operation.

Cash payments have been ruled out as unethical, but the authority has agreed to allow free sterilisation to be offered in return for egg donation.

Patricia Wejr, of the Women’s Health and Reproductive Rights Information Centre, said: “I don’t think more of this kind of treatment on the NHS is the answer. More resources need to be channelled into basic services”.

Infertility is commonly due to damage to the fallopian tubes. “More prevention is needed”, Ms Wejr told healthmatters. “The vast majority of tubal problems could be prevented by prompt and effective treatment of pelvic infection.”