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IVF patients need personally tailored support from doctors to make informed decisions
People struggling with infertility have very different views on the medical evidence surrounding treatment and need personally tailored support from doctors to make informed decisions, according to a study from Queen Mary University of London recently published in the journal Sociology of Health and Illness. Photo credit: Queen Mary University of London Over 50,000 people undergo fertility treatment in the UK every year, and an estimated 70% of them use controversial “add-ons” that promise to increase their chances of having a baby but are not backed by solid evidence. Most fertility treatments in…
IVF patients need personally tailored support from doctors to make informed decisions
People struggling with infertility have very different views on the medical evidence surrounding treatment and need personally tailored support from doctors to make informed decisions, according to a study from Queen Mary University of London recently published in the journal Sociology of Health and Illness.
Photo credit: Queen Mary University of London
Over 50,000 people undergo fertility treatment in the UK every year and an estimated 70% of them use controversial “add-ons” that promise to increase their chances of having a baby but are not backed by solid evidence. Most fertility treatments in the UK are privately paid, with prices ranging from £3-5,000 for a standard IVF cycle to more than £20,000 with certain add-ons. Therefore, it is important that patients can make decisions based on medical evidence rather than healthcare marketing.
Private fertility care providers are often accused of manipulating vulnerable patients for financial gain, according to a BBC Panorama film about IVF clinics selling unproven or risky add-ons. However, research led by Queen Mary's School of Business and Management tells a different story: While some patients prefer to delegate decisions to their doctors, others actively evaluate add-ons and decide to take risks, especially if fertility treatment hasn't worked in the past.
Researchers conducted in-depth interviews with 51 fertility treatment patients across England aged 29 to 47, including those undergoing IVF in person and their partners. They found that patients shared a general understanding of what counts as medical evidence, but had different views on what was “good” or “enough” depending on their personal experience with infertility and IVF.
The study found that patients were expected to make their own decisions about which add-ons they wanted to receive - and while some wanted to critically assess the available evidence, around half preferred to leave the decision-making to healthcare professionals and simply follow their advice. The interviews also showed that patients viewed evidence in relation to their own experiences, calculated risks and made decisions based on what they had been through in the past or how many chances they thought they would have of trying for a baby in the future.
With the UK Fertility Authority (HFEA) currently considering penalizing providers for abusive add-on sales, and the Competition and Markets Authority currently reviewing fertility clinics' compliance with consumer protection guidelines, this new research provides timely evidence to inform these important discussions about the privatization of healthcare and how to help patients be informed in the emerging market to make decisions.
In light of the study, researchers urge health care professionals to rethink what “informed choice” means in a privatized system. Patients need high-quality information in an accessible format to enable them to make their own treatment decisions, but alternative strategies should also be explored to defend those who take calculated risks or consult their physicians.
Study author Dr. Manuela Perrotta, lecturer in technology and organization at Queen Mary University of London, explained: "The discussion around IVF add-ons often tells a story of predatory private clinics selling useless fertility treatments to gullible patients, which is just one side of a complex story that our research is working to unravel. Patients need to have an unbiased view in a simple way high-quality evidence so they can make informed decisions about their own personal treatment – but some prefer to rely on healthcare professionals to make these decisions, so it is important to recognize and respect this as a decision in itself.”
Our research challenges the view of IVF patients who are willing to uncritically accept or demand unproven and expensive treatments as a desperate act to increase their chances of having a baby; on the contrary, we found them actively making complex decisions in the intense and uncertain world of reproductive medicine. Patients who choose to pay for private treatment and access controversial additional services are not due to a lack of information or understanding, but are personally weighing the scientific evidence against their own unique fertility journey.”
Dr. Josie Hamper, co-author and postdoctoral researcher, Queen Mary’s School of Business and Management
Source:
Reference:
Perrotta, M., et al. (2022) Patient-Informed Choice in the Era of Evidence-Based Medicine: IVF Patients' Approaches to Biomedical Evidence and Additions to Fertility Treatment. Sociology of health and illness. doi.org/10.1111/1467-9566.13581.
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