“Desperate Couples at Risk of Exploitation”- Dr John Waterstone

The Government needs to hasten plans to regulate fertility clinics in Ireland to avoid the potential “financial exploitation” of patients, it was claimed yesterday.

Dr John Waterstone, medical director of Waterstone Clinic, was responding to allegations that UK clinics are charging for costly “add on” treatments which are of no benefit in improving a woman’s chances of having a baby. Fertility clinics are not regulated in Ireland, despite pledges by several governments.This Government has promised to regulate clinics, but the drafting of the scheme in the controversial area will not be completed until 2017. It then faces more delays as it is submitted to the Joint Oireachtas Committee on Health and Children for pre-legislative scrutiny.

The BBC ‘Panorama’ programme claimed “add-ons” in UK clinics include a wide variety of treatments such as pre-implantation genetic screening – where the chromosomes of conceived embryos are checked for genetic conditions – and transfer of a “mock” embryo, as well as various drug treatments for blood clotting and immunity.

They reviewed 38 interventions offered by private clinics, and found most of them aren’t supported by good evidence. The NHS watchdog, the National Institute for Health and Care Excellence (NICE), only provides clear recommendations for the use of 13 of these treatments. Most of these should only be used in specific circumstances.

Systematic reviews have been carried out for 27 interventions. But there is only evidence that a handful actually improve live birth rates. Even then, the underlying studies behind the reviews have quality issues. Dr Waterstone said that the Health Department needs to be aware that an aspect of assisted reproduction (AR), which urgently requires regulation, is the potential “financial exploitation” of patients desperate to have a baby.

“The increasing commercialisation of AR everywhere has not been addressed sufficiently by regulatory systems in other jurisdictions, but needs to be in Ireland,” he said. “It is all too easy to attract unsuspecting patients by quoting inflated and unsubstantiated ‘success’ rates and then relieve them of several thousand more euro than they had anticipated spending in the course of an IVF treatment cycle.” This can be achieved by suggesting a variety of add-on adjuncts to routine treatment.

Such tests and treatments which are not warranted medically but are all expensive, he added. “None are likely to increase the chance of taking home a baby,” he said.

Helen Browne, of the National Infertility Support and Information Group, urged people in this country to do their research in advance. She said more people may now go to the UK because of the sterling difference.

A spokesman for the Department of Health said overcharging claims had not come to its attention. He said the Medical Council’s guide to professional conduct and ethics sets out the principles of professional practice all doctors registered with the council are now expected to follow – and this includes a duty of care to all patients fertility clinic patients.