The baby business: Watchdog to crack down on the 'scandal' of IVF clinics

HFEA acts as Lord Winston accuses fertility centres of claiming 'impossible' success rates and charging exorbitant fees

Brian Brady
Sunday 22 May 2011 00:00

Britain's fertility watchdog is to launch a crackdown, forcing private IVF clinics to stop making exaggerated claims about success rates, amid growing complaints that some have been "misleading" patients and charging exorbitantly high fees.

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The Human Fertilisation and Embryology Authority (HFEA) confirmed last night that it will oblige clinics to "take a more responsible approach to patient information", to ensure websites gave vulnerable couples a realistic assessment of their chances of having a child.

The move comes in response to a scathing attack on the charges and claims made by many private fertility clinics by one of Britain's top fertility experts. In a fierce attack on private IVF clinics and the body that is supposed to control them, Lord Winston complained about the "scandal" of clinics overcharging for treatment, accusing them of using "misinformation" to make their success rates appear better, and behaving in a "dishonest and dangerous" way by offering treatments abroad that are not acceptable in the UK.

"There are clinics that treat patients for around £3,400 a cycle," he said. "It is only when you look at their websites that you see they are charging up to £1,100 to £3,200 for drugs that should be obtained on contracts at around £500 to £700 per cycle."

The Labour peer complained that clinics charged up to £915 to freeze embryos – with storage fees of £325 a year – when the liquid nitrogen needed to carry out the job costs "a few pence a litre". Childless couples have often had to pay out tens of thousands of pounds in a desperate bid to realise their dream of having a baby of their own – sometimes with no success.

Desperate couples spend an average of £5,000 in pursuit of a child of their own, often blind to the harsh truth that clinics' claimed statistics about success bear little relation to the number of IVF babies who make it to live births. In extreme cases, couples are spending up to £40,000 to have a child.

In the UK some 15,000 children are born as a result of IVF every year – but fewer than one in four IVF cycles results in a live birth. With NHS fertility provision under intense financial pressure, some 30,000 of the 40,000 patients undergoing IVF treatment every year have had to hand over thousands of pounds to private clinics, many of which have been accused of making "quite incredible" claims about the success of their treatments.

The most recent national figures show that almost 40,000 women had IVF treatment in 2008, an increase of 8.2 per cent on the previous year.

Although NHS guidelines recommend that eligible couples are offered up to three cycles of IVF, funding cuts have forced a number of health trusts to restrict access to fertility provision; some have even suspended artificial insemination treatment altogether. Up to 80 per cent of IVF work is carried out in the private sector, where the average cost of a cycle is £3,500 – with extras, including hormone treatments, costing thousands more.

Jenny Hall, who runs Origin Fertility Care in Belfast, said: "You have longer waiting lists for NHS treatment, with a postcode lottery restricting access in some areas, and private clinics with spare capacity to take the people who need this treatment. I'm not saying that doctors are always untrustworthy, but they have a vested interest, and they are working with a captive and vulnerable audience."

But Lord Winston also questioned whether potential patients were given an accurate picture of the industry's performance: "Another clinic argues that it has a 30 per cent success rate in women over 40 or 42. That is a biological impossibility given that the implantation rate alone of a patient under 40 is something around 18 per cent per embryo – at best 25 per cent.

"What the site does not say is that this is for pregnancy, not delivery of a live baby. It does not take into account the vast number of miscarriages that presumably these patients are going through. This kind of misinformation occurs again and again."

The dramatic intervention, during a House of Lords debate on the future of the HFEA and a host of other quangos threatened by government cuts, raised serious questions over the watchdog's performance in controlling standards among dozens of clinics.

An HFEA spokesperson rejected the "misplaced" criticism of the body's failure to control the costs patients have to bear, but conceded that claims made on clinics' websites were a concern. He said: "We are about to launch an initiative to work with centres to take a more responsible approach to patient information."

Lord Winston singled out The Bridge Clinic, in London, which advertises a 71 per cent pregnancy rate for blastocyst treatment and 67 per cent success for pre-implantation genetic diagnosis. He said: "As someone who has been intimately involved with pre-genetic screening of this kind, I find those figures, frankly, quite incredible."

A spokesman for The Bridge last night said he was "surprised" by the comments, insisting the website information was "factual and as up-to-date as possible". He added: "Public-sector IVF centres work to an entirely different cost model when compared with the private sector, with substantial areas of overhead supported by the taxpayer, making valid financial comparisons rather difficult."

Clare Lewis-Jones, chief executive of the patient charity Infertility Network UK, said "It is vital that patients make sure they are fully informed about the costs of treatment and ensure there are no sudden surprises. We would be very concerned if clinics were over-claiming on success rates, and if this is the case we would urge the HFEA to look into this."

Dr Kevin Lindsay, a specialist in reproduction at the Imperial College Healthcare NHS Trust, in London, said: "As with any business, selected information is often used as an advertising tool and is likely to be misleading if taken at face value. Unfortunately, 'buyer beware' applies."

But Brian Lieberman, a former HFEA member, said that clinics, particularly in London, had to cope with stiff competition and high business costs.

The mother's story

Film-maker and novelist Rebecca Frayn, now 49, of west London, and husband Andy Harries, a TV executive and producer, spent about £6,000 of their savings on one course of IVF to conceive daughter, Emmy, now 10. They had tried to conceive naturally for three years

"I have identical twin boys [Jack and Finn, now 18] conceived naturally. When we wanted a third child we discovered my husband had a low sperm count so IVF was the only way we were going to conceive.

"We went privately because I was in my mid-thirties and I didn't want to be put on a waiting list. I knew time was important.

"To be honest, it's hard to know whether you can afford it because you have no idea how many treatments you might be facing. We could afford a first treatment and then we were going to have to have a long talk and decide, if it hadn't worked, whether we could have afforded to try again.

"I had one treatment and that was successful. They put you through one cycle where they close down your system; it must have been about two months of drugs. And then they put you on drugs to massively stimulate the ovaries.

"I thought it was so gruelling and harrowing that it inspired me to write a novel, which I published a few years later, called One Life. Although I was very lucky and had two children; although I was very lucky to conceive in that first cycle, the idea that some people are locked in that cycle of hell over and over again blew my mind. I thought it was a truly, uniquely ghastly and horrible experience.

"The costs pile up. I think you are given an initial cost and then they keep adding a new stage and that seems to have a new cost. I don't think we fully understood what we let ourselves in for when we embarked on it.

"The costs seemed to my husband and I – as a couple who paid out – to be astonishingly high and if Robert Winston, who knows the system from the inside, is confirming that they don't need to be that high, that is a grave concern. Having said that, as a couple who were very, very fortunate and conceived a beautiful, intelligent, athletic daughter, the other side of the argument is that it is a priceless gift.

"There is no sum of money that I could have put on the joy and good fortune of having conceived her."

Kate Youde

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