IVF success rates 'misleading'

Success rates advertised on the majority of IVF clinic websites are highly misleading, even if published in good faith, because they 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.

"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.