IVF ‘add-ons’ are a toxic cherry on a cake iced with desperation and hope

Not all patients who seek fertility treatment are desperate like I was when I sought the help of an IVF specialist. But like anyone seeking medical intervention, IVF patients are vulnerable, often feel powerless and have dreams of starting or completing their family. Often they have also traversed varying forms of grief and loss. When this is combined with a profit-driven industry, you have a recipe for disaster.

The IVF process is horrendously expensive and incredibly invasive. Statistically, only one in four transferred embryos will result in a live birth. Of the people who don’t get pregnant on their first try, only half will get to a third attempt. The most cited reason for abandoning treatment is “psychological stress”. Put simply: no one would choose to have IVF for shits and giggles.

In the past two months, we’ve seen two cases of the wrong embryos transferred into patients.Credit: Istock

In the past two months, we’ve seen two cases of Monash IVF admitting to transferring the wrong embryos into patients, two other major clinics provide incorrect information to sperm donors, and a class action against a number of IVF companies for add-on genetic testing that may have incorrectly found embryos were “abnormal”, settle for $56 million.

Nowhere is the toxic combination of “baby want” and profit-seeking more evident than IVF add-ons. These additional “treatments” are offered to allegedly improve the likelihood of a live birth. Examples include endometrial scratching (scratching the uterine lining to improve the chance of implantation), assisted hatching (a small hole is made in the outer layer of the embryo to aid implantation), and embryo glue (believed to improve embryo attachment to the uterine wall).

The cost of these additional treatments can range into the thousands of dollars, but research published by the University of Melbourne in 2021 found that 77 per cent of the 40 Australian IVF clinic websites analysed make “unsubstantiated claims of benefit about add-ons”.

Dr Karin Hammarberg, a senior research fellow at Monash University’s School of Public Health and Preventative Medicine who has extensively researched IVF add-ons, says some add-ons have little to no evidence to support their use, and in some cases may have adverse effects.

Though none of these add-ons are mandatory, when you speak to a vulnerable person spending thousands of dollars on a treatment and suggest, even subliminally, that these extra treatment options might improve their chances of realising their family, of course they’re going to pony up.

Speaking to this masthead last week after the latest bungle came to light, Professor Gab Kovacs, who spent decades in the Australian IVF sector, said that what happened “is human error, and it will happen again,” adding, “Probably, there are other mix-ups at other clinics that we don’t know about.” It’s chilling to consider.

But beyond these high-profile mishaps, there are also plenty of lower-grade, though nevertheless traumatic, incidents occurring. One person I spoke to was given the wrong timing for their “trigger shots” (an injection given at a very precise time to trigger the body to complete ovulation ahead of an egg collection), which put them at risk of having to restart their egg collection round from scratch. Like others, they were offered free treatment after this event due to the stuff-up.

I also know of patients who, on the same phone call they learned they had miscarried, were told they were welcome to put a deposit down for another round, with no referral for support or counselling.

This is what happens when people are riding the service conveyor belt that’s all too common in IVF. Where is the duty of care?

Make no mistake: there are many exceptional, empathetic, caring, capable and terrifically talented professionals working in the IVF space. Many parents wouldn’t have their children if it wasn’t for these treatments and those who administer it.

But there are structural issues that have been left unaddressed for decades, and vulnerable people are paying the price, literally and figuratively.

We know the fox guarding the henhouse doesn’t work. Let the errors that have come to light be the catalyst for genuine change that results in better transparency, equality, access and oversight, for a sector that has been left to its own devices for far too long.

Isabelle Oderberg is a journalist and communications strategist, and the author of Hard to Bear: Investigating the science and silence of miscarriage. She is the co-founder and executive director of the Early Pregnancy Loss Coalition. She has seven angel babies and two living children.