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Are fertility clinics giving couples ineffective IVF treatments?

When she's not writing, Claire Gillespie can most often be found wiping snotty noses, picking up Lego, taking photos of her cat or doing headstands.

IVF is enough of a gamble without couples getting ineffective treatments

Most of us know someone who has been through IVF and how stressful and terrifying that can be. It really doesn’t help when a leading fertility expert warns that the most popular form of IVF is ineffective and costly.

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Professor Hans Evers of Maastricht University, who is editor-in-chief of the Human Reproduction journal, said IVF clinics have been providing couples with an expensive IVF add-on treatment that may actually reduce their chances of getting pregnant.

The treatment is intracytoplasmic sperm injection, which was used by 455,000 couples across the world in 2010. During ICSI, a single sperm is injected into an egg to fertilize it. It was developed for couples in which the man has been diagnosed with severe male infertility. But while only 30 to 40 percent of couples' problems are caused by severe male infertility, there was 2.7 times as much ICSI than IVF in North America in 2010. According to Professor Evers, the ideal figure is 0.66 ICSI treatments for every one of IVF.

Basically the numbers don't add up. So what's going on?

ICSI costs around $1,500 per cycle, adding to the already substantial cost of IVF. Naturally Professor Evers' claims have triggered concerns that some IVF clinics may be promoting this treatment to boost profits.

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Professor Evers said that inappropriate treatments should be weeded out and that clinicians needed to stop "playing Santa Claus and doling out nicely wrapped presents of unnecessary, ineffective and costly care." Except they're not exactly playing Santa Claus when they're charging couples $1,500 a pop for something they don't need, right?

The most concerning aspect of Professor Evers’ claims is that ICSI could lower a couple’s chances of conceiving — the opposite of what they are longing for. Studies show that ICSI results in fewer live births than IVF does when used for couples where severe male infertility is not an issue.

"Intending to improve their patients' pregnancy probability by preventing fertilization failure, well-meaning doctors actually decrease their chances," said Professor Evers. "This has to stop. We have pledged to do no harm."

A study of 300,000 births found that 1 child in 10 born following ICSI had a defect, including a cleft palate, heart and lung conditions, cerebral palsy and blood disorders, which is twice the level of the general population's. On the other hand, standard IVF has no extra risks compared with natural births.

Fertility expert Professor Geeta Nargund told Daily Mail, "ICSI is also an invasive technique which is not without risk. Where possible we should be using more natural and less invasive methods for conception. We have a duty and an obligation to reduce invasive techniques, to reduce the cost to patients, to make treatment as natural and as safe as possible."

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