A Systematic Assessment of In Vitro Fertilization Add-On Interventions on Canadian Clinic Websites: A Cross-Sectional...

Area of Science:

• Reproductive Medicine
• Health Services Research
• Medical Ethics

Background:

• In vitro fertilization (IVF) add-ons are supplementary treatments marketed to enhance success rates.
• Evidence supporting many IVF add-ons is limited, prompting professional organizations to advise caution.
• Patient understanding of add-ons is often shaped by information presented on clinic websites.

Purpose of the Study:

• To analyze the descriptions of IVF add-ons on Canadian clinic websites.
• To assess how pricing, benefits, and harms of add-ons are communicated to patients.
• To evaluate the quality of evidence cited for IVF add-ons on these platforms.

Main Methods:

• A cross-sectional study systematically reviewed 42 Canadian IVF clinic websites.
• Add-on information was contextualized using recommendations from Choosing Wisely Canada and ESHRE.
• Website content, pricing, and cited evidence quality (Oxford Levels of Evidence) were analyzed.

Main Results:

• Nearly all (97.6%) reviewed websites described at least one IVF add-on, with 17 distinct interventions identified.
• Pre-implantation genetic testing for aneuploidy and sperm DNA fragmentation testing were most common.
• Benefits were mentioned in 50.4% of descriptions, harms in 22.5%, and only 7.1% cited low-quality publications.

Conclusions:

• Canadian IVF clinic websites frequently promote add-ons with limited evidence.
• There is a need for clearer communication regarding the evidence base, risks, and cost of add-ons.
• Distinguishing standard care from discretionary add-ons is crucial for informed patient decision-making.