Private IVF clinics offer ‘discredited’ €1,000 test
Private fertility clinics are selling Irish couples €1,000 blood tests despite experts warning that there is no proof that the procedure improves the chances of having a baby.
The test is sold by Beacon Care and Sims fertility clinics. It is part of a reproductive immunology procedure offered to women who have had multiple miscarriages after rounds of IVF.
Both Beacon Care and Sims, two of the biggest private fertility clinics in the country, offer immunology testing and treatment for “natural killer” cells, which is one of the most controversial areas of reproductive medicine, according to a leading Irish fertility doctor.
The so-called Chicago test costs €1,000 plus a consultation fee. The blood is sent to the US city to be examined to see if the woman’s immune system is attacking embryos and causing miscarriages. If elevated levels of the killer cells are found the woman can be prescribed drugs to suppress her immune system, which can cost thousands of euros per dose. This is usually after multiple rounds of IVF treatment costing an average of €4,500 per cycle.
Researchers and fertility authorities have said that testing blood for such cells is not useful. When contacted by The Times yesterday, the medical director of Sims said that the clinic would likely withdraw the test in the near future.
The Human Fertilisation and Embryology Authority, the UK regulator, has said that the theory behind reproductive immunology has been “widely discredited and there is no evidence that immunosuppressive therapies can improve your chances of getting pregnant”.
It said that there was not enough evidence to support the effect of the killer cells in the uterus and that “safety and efficacy questions surrounding the use of immune therapies in IVF remain unanswered”.
Mary Wingfield, clinical director of the Merrion Fertility Clinic, which is linked to the National Maternity Hospital, said that she agreed with the UK regulator’s warnings about natural killer cells and that the commercially available tests were “extremely variable and unsatisfactory”.
“Until satisfactory evidence becomes available, testing for and treating presumed immune and [natural killer] cell dysfunction in women with reproductive problems should only be done as part of clinical studies and trials,” Professor Wingfield wrote in her book The Fertility Handbook.
The government has agreed to draft new legislation to offer financial assistance to couples struggling to conceive. The law would also establish an independent body to oversee the sector.
John Kennedy, medical director at Sims, said that the Chicago blood test was no longer routinely sold at its Dublin and Cork clinics and that a biopsy was now recommended to test for killer cells. He said that demand for the test was patient-led.
“It is something we are considering withdrawing but we offer it because if we don’t people will just go abroad or to another clinic,” he said.
Dr Kennedy said there was some evidence for reproductive immunology but the limits were explained to any couple treated at Sims. He added: “Across modern medicine there is a huge swathe of things that are done with limited evidence for them.” He said patients were told that there was no certainty that any treatment would work.
Ahmed Omar, clinical director of Beacon Care, said that the Chicago test was one of a number of investigations offered to patients who had suffered repeated IVF failures or miscarriages.
“We counsel them that immune testing may only be beneficial for women that other causes for treatment failure or pregnancy loss have been excluded. We explain that elevation in natural killer cells is one of many risk factors but due to the complexity of human embryo implantation it is difficult to be certain about what is a single cause for treatment failure,” he said.
Dr Omar said that there was “a general acceptance of the role of immune issues in some cases of [IVF] failure and miscarriages” but that there was a lack of randomised control trials to assess the benefits of the treatments available.