Complementary modules of fertility under control – which patients demand

The NHS and private fertility clinics are invited to stop offering treatments that are not proven to help people design, according to new advice projects from the National Institute for Health and Excellence of Care (Nice).

The recommendations, currently open to the consultation (I will be back to report on the result in a few weeks), highlight several “supplements” fertility This research does not suggest improving results. They also offer access to the expansion of fertility preservation services, such as egg freezing, for people whose fertility can be at risk due to medical conditions.

Although the consultation is launched, decompose what is in the new guidelines and answer some of the most common questions of patients concerning additional modules, costs and risks.

What are the complementary fertility modules?

The authority of fertilization and human embryology (Hfea) Defines complementary modules as procedures, tests or additional drugs offered in addition to standard fertility treatment, generally at an additional cost.

A Recent HFEA survey Found that nearly three -quarters of patients had used at least one additional module, but only 37% said the risks had been explained to them. BBC reports This kind now advises the clinics of Stop offering several of these treatments Apart from research contexts.

Under the spotlight in the Nice advice project are: ”

Everything caught up? Let’s make the details.

What is ICSI treatment?

Intracytoplasmic sperm injection (ICSI) involves injecting a single sperm directly into a laboratory egg. It is generally recommended for Male factor infertilityLike the very low number of sperm.

ICSI treatment cost

The costs vary between clinics, but ICSI is generally billed as an additional procedure in addition to IVF costs.

ICSI risks

Although widely used and effective for certain causes of infertility, ICSI also has risks. Studies have raised questions about Long -term health implications For offspring, although the results remain under investigation. Nice guidelines projects specifically advise the use of ICSI in men with healthy sperm, where standard IVF is generally sufficient.

Why don’t the eggs fertilize with the ICSI?

Even with ICSI, fertilization is not guaranteed. Factors such as the quality of eggs, the quality of sperm and underlying medical conditions can all affect the result.

What is endometrium scratches?

The writing of the endometrium is a procedure where the factory lining is gently “grouped” with a small sterile tube, generally before the transfer of embryo. We thought it improves location rates.

The latest Nice advice project advises to offer it as a complementary module, due to the lack of evidence that it improves the results of IVF.

What is hysteroscopy?

Hysteroscopy is a procedure that allows doctors to look inside the uterus using a fine telescope type instrument called hysteroscope. It can be used to check problems such as polyps, fibroids or scars, and can also be performed to study heavy periods or a repeated miscarriage.

In fertility care, some clinics have offered hysteroscopy as an additional pre -treatment module, in the hope that examining or cleaning the USAGE lining could improve IVF results. However, in his updated guide project, Nic advises the use of hysteroscopy only as a complementary procedure, because there is no clear evidence that it increases the chances of pregnancy.

Hysteroscopy cost

Costs may differ considerably depending on whether it is carried out in the NHS (when clinically necessary) or in private as part of fertility treatment.

To what extent is hysteroscopy painful without anesthesia?

In terms of experience, pain levels vary. Some people point out a slight discomfort, while others find it painful, especially without anesthesia.

What is the era test?

The Endometrium Reception Analysis test (ERA) examines the expression of the genes in a factory lining sample, aimed at identifying the best time for embryos.

But is it worth it? The Nice guidance project advises the use of the ERA test as a routine supplement. Until now, the evidence suggests that it does not systematically improve the results of IVF.

For more details on the era tests and how he compares himself to other tests such as Receptivadx (and yes, they test for different things), see Our in -depth guide.

Nice updates – Fertility preservation recommendations

Beyond the additional modules, Nice recommends broader access to preserving fertility. Currently offered mainly to cancer patients, services such as eggs, embryo and freezing sperm could in the future be extended to people with conditions that affect fertility, such as severe recurring endometriosis. We are the fans – look at this space.

IVF access and cycles

Nice has also examined evidence on the number of IVF cycles that should be offered. He now recommends:

• Up to three full IVF cycles for women under the age of 40 who meet certain criteria
• A complete cycle for women aged 40 and 41, according to specific criteria
  

While Nice exposes advice, decisions on financing remain with the integrated care councils of the local NHS.

What happens next?

The project of directives covers England, Wales and Northern Ireland. They are open to consultation until October 21, 2025With final recommendations due in 2026.

Dr. Fergus Macbeth, Chairman of the Nice fertility directives committee, said:

“People who go through fertility treatment are often ready to try everything that could help them to design. This makes them vulnerable to be offered treatments that seem promising but have not been properly tested. ».

We will be back as soon as the recommendations update, with all the information and more in -depth reading.