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.
- evidence-based medicine
- patient information
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Contributors CH and EAS conceived the study design, extracted and analysed the data. BG, KRM, CH and EAS all contributed to the methods and the writing of the manuscript and approved the final draft.
Funding This project received no specific funding. CH receives funding from the National Institute of Health Research (NIHR) School of Primary Care Research; 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; and KRM is funded by a NIHR clinical lectureship.
Competing interests 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.
Provenance and peer review Not commissioned by BMJOpen; externally peer reviewed. This work arose after BBC Panorama asked the Centre for Evidence-Based Medicine (CEBM) to carry out an independent review of the evidence for fertility treatments additional to IVF. The BBC had no role in the review's protocol, methodology, or interpretation of findings but were kept aware of its progress. Deborah Cohen, the reporter of a BBC Panorama on fertility treatments, is a freelance editor at The BMJ.
Data sharing statement A copy of the full supplementary table of data extraction of each website is available on request from the corresponding author.
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