From Endometrial Scratching To Embryonic Glue, Should IVF “Adds-Ons” Be More Heavily Regulated?

“We all stopped using nail varnish. And eating out of tupperware. I went for acupuncture and nearly tried reflexology.” Sitting in a restaurant, her son asleep in a buggy beside her, my friend is describing just a few of the things she tried, during IVF, to increase her chances of conception.

To sacrifice a manicure or rethink your leftovers are, in the grand scheme of things, small prices to pay in the pursuit of a longed-for pregnancy. Adjusting your lifestyle and reordering your priorities are things that many expectant and hopeful parents do, whether they are using fertility assistance or getting knocked up the old-fashioned way. But there are other measures – suggested procedures – that are rather more invasive. Other approaches that are significantly more expensive and with equally unreliable results.

This week, the Welsh MP Alex Davies-Jones has launched a campaign for there to be more regulation of IVF in Britain. Specifically, the kind of expensive add-ons, sometimes offered by clinics, that have little scientific or medical evidence to back them up. Things like endometrial scratching – where a small area of the womb lining is scraped to try and help the embryo implant – or creating a small crack in the embryo’s outer layer to encourage “hatching”. Regulating the industry – because it is an industry – would, as the politician and parent put it, stop “vulnerable people being preyed on” by private fertility clinics.

I was very lucky with my first pregnancy. Despite the early onset of my mother’s menopause and the frankly unknowable state of my womb when I came off contraception, I got pregnant without fertility treatment. In fact, I got pregnant so soon that my partner sometimes jokes that he had just a week between agreeing to try for a baby and becoming an expectant parent. And yet, as a 37-year-old woman of the world, many of my friends have used fertility treatments or have become pregnant as a result of IVF. In many cases, the experience was physically uncomfortable, logistically challenging and emotionally draining. It was also, for those in same-sex relationships, single people, those whose partners already had children or who had already gone through the rounds available on the NHS, expensive. A single round of IVF can cost thousands of pounds – a price that is simply beyond the means of many people in this country.

The add-ons highlighted by Alex Davies-Jones include, alongside endometrial scratching and assisted hatching, something called “embryo glue”. According to the BBC, the Human Fertility and Embryology Authority (HFEA) have reported that 74 per cent of IVF patients included add-ons in their treatment. I remember coming across some of these phrases, and the rates of live births that followed, when I was researching my book. Perhaps it was the language used but I immediately thought of horse racing. Of the shady, superstitious and sometimes outright unethical activities some trainers and jockeys undertook to try and secure poll position. But this isn’t gambling, or sport; it’s fertility. Still, the question facing many parents is whether to take the risk, hand over the money, when facing those odds. Well, of course, if you want a baby more than anything, and have the means, the pressure to try these things is huge. Who, after all, wants to be looking at a negative pregnancy test wondering if that extra few grand would have made all the difference?

IVF, I think it’s fair to say, sits in a sometimes uncomfortable position between healthcare and private business. It can be offered by clinics that attend to both NHS and private patients. It is a medical procedure. And yet, in part, it also functions as an industry. It makes money for the people administering it, paid for by the people who need it. That means patients undergoing IVF are vulnerable to a particular kind of pressure – a combination of hope, promise, scientific-sounding description and anecdotal success. A pressure – however subtle – that might see them hand over large sums of money in order to improve what they understand as their chances.

I haven’t undergone IVF yet. Maybe I never will. But I do believe that the desire for a baby can be overwhelming. And in that vulnerability we should be respected, not exploited.