In vitro fertilization (IVF) is the only option for many couples who want to have their own genetic child. This is an expensive procedure – it can cost up to $20,000 per attempt, with about a 40% success rate overall.
Couples going for IVF are often desperate to have their own child, and the uncertainty of success can be emotionally and financially draining. For this reason they are an especially vulnerable population when it comes to optional services (“add-on services”) that promise to increase the chances of success.
A recent BMJ article reviewed the evidence for 38 IVF add-on services typically offered in the UK: “Lack of evidence for interventions offered in UK fertility centres.” The title gives away the punch line – of the 38 services they reviewed, only one had any compelling published evidence of efficacy, endometrial scratch (causing minor trauma to the uterine wall to enhance the probability of embryo implantation). Even then the evidence was only “moderate.” The authors write:
Our appraisal of the evidence shows only one intervention, endometrial scratching, for which the review evidence robustly supports an increase in live birth rate, yet even this evidence is of only moderate quality, and the observed benefit is only in women with more than two previous embryo transfers.
That could easily be just random noise in the research. If you look at 38 different treatments, what are the odds that at random one of them will have an excess of false positive studies, and only in one subgroup (which is a red flag)?