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Response to Panorama’s ‘Inside Britain’s Fertility Business’ – 28th November 2016

We welcome the Panorama investigation shown last night on BBC1 on the role of so called "add ons" in IVF treatment, and the accompanying scientific article by Professor Carl Heneghan and colleagues at the University of Oxford published in the British Medical Journal.  Here in the NHS at St Mary's we conduct ongoing research into many aspects of IVF treatment including add ons and in our clinic we offer only treatments with firm evidence.  We  include in our routine IVF treatment the three add ons identified by Heneghan and colleagues as supported by evidence - blastocyst culture, embryoglue, and endometrial scratch, at no extra charge.  Actually we do not consider blastocyst culture to be an add on, however as it involves keeping the embryo in the laboratory for longer it is important that it is performed in the safest way possible using low oxygen levels and a high quality environment.

Of the controversial "add ons" highlighted by Panorama, preimplantation embryo genetic screening and immune therapy have never been offered at St Mary's as we agree that there is currently no evidence to support their use.  We do use timelapse embryo incubators, in fact we were the first centre in the UK to have these, however this is because the incubators are much higher quality than others available and are important in offering safe blastocyst culture.  We do agree with the Panorama team that currently there is little evidence supporting the use of the embryo images obtained from timelapse in selecting embryos and certainly patients should not be being charged for this.

We fully support the call by Panorama and Heneghan et al for more research into add ons and in fact at St Mary's we have conducted for many years a high quality externally funded research programme in this area.  We have just completed participation in the Habselect clinical trial into the impact of sperm DNA damage and we are now carrying out both the Endoscratch trial into endometrial scratching and the EFREEZE trial into the use of embryo cryopreservation, funded by NIHR.  We also have a basic research programme funded by the MRC, EU and Diabetes UK into the efficacy and safety of IVF technologies such as embryo freezing, blastocyst culture, low oxygen and embryoglue on IVF outcomes and child health.

We are firmly committed in our clinical practice and research and development to ensuring the best possible outcomes for couples attending St Mary's for IVF treatment and children born through IVF.