HFEA helps patients to make informed choices with new factsheet on controversial fertility treatment
30 June 2005
People seeking fertility treatment are getting extra information and support in one of the most controversial new areas of fertility tests and treatment with a new factsheet from the Human Fertilisation and Embryology Authority (HFEA), the UK regulator for fertility treatment.
The factsheet covers the area broadly known as ‘reproductive immunology'. This is the belief that some fertility problems are caused by a woman's immune system reacting against sperm, preventing fertilization, or against an embryo, which either stops the embryo from implanting, or rejects the embryo early in pregnancy, causing a miscarriage.
Consequently, some clinics have begun to recommend tests and treatments, including:
- Endometrial biopsy (a procedure to remove a small sample of the lining of the uterus)
- Drug treatments
- Intravenous immunoglobin [IVIG] (a transfusion of antibodies)
However, there has been a fierce scientific debate in this area with some scientists and doctors saying this new treatment has real benefits, while others believe it has no value at all.
The HFEA share the view of the Royal College of Obstetricians and Gynaecologists (RCOG) Science Advisory Committee that there is not enough evidence available at the moment to justify the blood tests, examinations (such as endometrial biopsies) and drugs that may be involved in testing and treatment.
These new treatments can be an expensive addition to IVF costs and as with all medical interventions, carry with them risks and potential side effects. They have caused debate among the medical profession as to the demonstrable benefit of these treatments for patients.
Clinics do not need a licence from the HFEA to carry out reproductive immunology tests and treatment, but the HFEA feels it is important that patients are fully informed about all possible aspects of fertility treatment that they may be offered by their clinic before they make decisions about their care.
Suzi Leather, Chair of the HFEA said:
"Reproductive immunology is a new and developing area of fertility treatment which some clinicians believe can make a very real difference to a woman's chance of getting pregnant. However, because this area of science is so new, there is no conclusive evidence that these treatments work – but neither is there any conclusive evidence that they have no value.
"We feel it is important that people seeking fertility treatment are aware of reproductive immunology tests and treatments. This way, they can have an informed discussion with their doctor if the matter arises. If people have better information on this area we can help them get the best out of their time with their doctor and make the choice that is right for them.
"The cost of these tests and treatment along with the potential risks for patients could add to the stress of fertility treatment at what is already a worrying time and we feel that by providing balanced information on this matter, we can lessen anxiety for fertility patients.
"The HFEA is continuing to monitor the developments in this area and to gather any new evidence which would result in an answer to the value of these treatments to patients."
Notes to editors
The HFEA is the independent regulator for IVF treatment and embryo research. Our role is to protect patients and the public interest, to drive improvement in the treatment and research sectors and to provide information to the public and policymakers about treatment and research.
The HFEA was set up in August 1991 as part of the Human Fertilisation and Embryology Act 1990. The HFEA's principal tasks are to license and monitor clinics that carry out in vitro fertilisation (IVF), donor insemination (DI) and human embryo research. The HFEA also regulates the storage of gametes (eggs and sperm) and embryos.
Tests and treatments around reproductive immunology can cost more than £1000, in addition to any other treatment costs.
Read more information about reproductive immunology on the HFEA website.
For the most recent information on the medical debate, please see the most recent journal article in Human Reproduction, entitled: Natural killer cells and reproductive failure—theory, practice and prejudice (Rai, Sacks & Trew). Hum. Reprod. May 2005; 20: 1123 - 1126.
Page last updated: 11 March 2009