IT'S been four decades since Louise Brown became the first human to be been born after conception by IVF, and since then, there have been well over a million 'test-tube babies' born worldwide. But Professor Robert Winston, whose multi-award winning work on fertility treatments helped thousands of women give birth to happy and healthy babies, says the 40-year anniversary should be a time to re-evaluate its successes.
"The 40th anniversary is a time to celebrate the great happiness of millions of couples. But this achievement of Patrick Steptoe and Robert Edwards [who developed the IVF technique], and many other pioneers, is also a moment for most serious reflection," he says.
The leading fertility expert believes that many couples who are struggling to conceive and shelling out thousands of pounds on private treatment are being exploited by misleading statistics.
"Most people who go in for IVF are over the age of 35 and have a lower success rate than the national statistics show," says Winston. Yet despite this, he describes a "major problem" with private clinics "selling the dream" to desperate couples, leading people to believe they are much more likely to get pregnant than they really are.
With some clinics keen to profit from expensive treatments, he believes people don't always understand that the chance of getting pregnant from an individual IVF cycle in the UK still only stands at about 21 per cent if you're under the age 35 – the chances are even lower if you're older.
"The NHS and the HFEA [Human Fertilisation and Embryology Authority] websites are quite self-congratulatory if you look at them," he notes, "but the reality is, people are being sucked into IVF without a full recognition of exactly how low the success rate is.
"The HFEA records success rate per embryo transfer, but that in itself is misleading, because a large number of women start a cycle but never get to the embryo transfer stage, either because their ovaries don't respond or because the eggs don't fertilise."
Around one in seven couples may have difficulty conceiving in the UK – approximately 3.5 million people. The broadcaster and author, who has written more than 300 scientific publications, sees first-hand the negative psychological effects, along with the crippling financial issues, that conflicting or unreliable advice on IVF can have on couples.
He says he has spent the majority of his morning answering emails from patients desperate to understand why the IVF treatment hasn't worked for them. Through his work with The Genesis Trust (genesisresearchtrust.com) a charity seeking better health for women and babies, Winston aims give women factual and unbiased guidance. He has also long been vocal in his criticism of the commercialisation of the treatment.
He says the private sector is on a "gravy train" with IVF, with some clinics charging up to £8,000 for a single cycle of treatment, describing the combination of "desperation" from couples and "avarice" from private practices as a "dangerous combination".
Although official guidelines suggest would-be mothers under 40 should be given three free IVF cycles paid for by the NHS, patients are increasingly only offered one, or sometimes none at all. How many IVF cycles you're entitled to is up to local clinical commissioning groups to decide.
"The first thing we need to change, which is something we're not doing in reproductive medicine, is to regard infertility as a symptom," Winston says. "Right now, we regard it as a diagnosis and it's fundamentally wrong to offer a treatment on the basis of symptoms – because the underlying cause of the symptom will vary."
He says infertility might have "50, 60 or 70 different causes", and that it's therefore important to investigate the cause of the infertility to offer the best treatment, claiming there are often issues that could be resolved via cheaper and less stressful methods.
"In many cases, in-vitro fertilisation is not the best [treatment] – but it's the most profit," he says. "Unexplained infertility is a nonsense; it's a failure to make a diagnosis. People are reluctant to go through with investigations, which in my view are justified, because at the moment, so many patients are failing to get pregnant with an IVF cycle and then get pregnant after the IVF has finished.
"One of the important issues is making a diagnosis and finding other more effective simpler remedies, but most clinics are now geared up to do IVF, so they don't actually treat the underlying issue."
Winston says one of the most common causes of infertility in women is a hormone deficiency, which is usually better treated by drugs – yet few clinics offer this. He believes it's time to make a change.
"The 40th anniversary will be a cause for regret if we don't focus on better treatment, which is geared to the diagnosis. It's clear the success of IVF could be improved substantially, but without research... IVF will continue to cause great distress."
