Are unethical clinics cashing in on women’s vulnerabilities?

Eufemia Didonato

Most women will have around 15 eggs collected in a cycle, unless they have low reserves, according to the HFEA. Bagg’s cycle resulted in just five eggs being frozen. Though concerned that the relatively low number may not lead to a pregnancy, she had neither the money nor the emotional strength for further cycles.

‘When I had my fertility tests, I was told I had low AMH levels [anti-Müllerian hormone levels, used to assess a woman’s ovarian reserve or egg count] – lower than what a woman of my age would normally have. It worried me, but I didn’t understand that it meant I would get only a handful of eggs. I was never told how many eggs I had a chance of getting, or how many rounds I’d need to get a good number of eggs. And it didn’t occur to me to ask because I was focusing more on the success rates of the [overall] procedure.’

So, does she wish she’d pushed for clearer figures at that stage? ‘They can’t say, “We have 20 years of data,” as it’s a new procedure, but they could have told me a good average for a woman of my age with my AMH results, with the understanding of it being a small pool of data.’

She adds: ‘I don’t know if I would have done anything differently if I’d had all the information because I believe I did what was right under the circumstances, but it would have been good to have more information so I could have been prepared emotionally and financially.’

Egg freezing ethics

Gwenda Burns, chief executive of Fertility Network UK, is hopeful that things will change for the better when the CMA guidance is published in March. ‘This will help protect patients better and provide more transparency. We also want to ensure patients are not being offered add-ons without the appropriate clinical or scientific research behind it.’

These add-on treatments can be expensive. They include ‘assisted hatching’, where lasers or acids are used to help the embryo break out before it implants in the womb. The National Institute for Health and Care Excellence (NICE) clearly states: ‘It is not recommended because it has not been shown to improve pregnancy rates.’

Ethical questions have also been raised around controversial ‘freeze and share’ programmes, in which patients are offered financial incentives such as free freezing and storage, in exchange for giving away half of the eggs collected from them. One academic previously described it as tantamount to ‘bribing women’ in a ‘capitalist marketing ploy’. And while it helps make egg freezing available to those who couldn’t otherwise afford it, there are emotional issues to consider.

‘The greatest fear for many women considering this is that the treatment fails for them but the eggs they’ve shared have been successful for someone else,’ says Gwenda Burns. ‘That could have a significant impact from a mental health point of view.’

Clinics also cash in by offering financial incentives such as ‘buy one, get one free’ deals on egg-retrieval cycles, and ‘free freezing for the first year’ offers. Often these are helpful – but some clients complain that the costs aren’t transparent enough.

Sarah Brocklehurst, 49, a fitness trainer from London, froze her eggs at 41, and was stunned to discover that the annual storage costs for her eggs, which had started at £200, shot up to £360 within a year. ‘I asked them to justify where the additional costs came from, but those questions were never answered,’ she says. ‘I think it should be made clearer to women that the price can change.

‘I said, “Maybe I’ll take my eggs out to another clinic,” and they made me aware that if you move your eggs, there’s a fee to release them. That’s something I didn’t know beforehand either.’

‘Second-hand car salesman’ techniques

Then there are the ethics of discounted deals. ‘Anyone in marketing would think, “Let’s capitalise on this increase in interest [during Covid],”’ says Andrea Syrtash of Pregnantish. ‘But fertility isn’t the same as other things we market. The stakes are incredibly high – this is literal life. So patients need a lot of support and information [before signing up for] these bundles. 

Alice*, 43, a marketing consultant from London, looked into egg freezing when she was 36 and newly single. ‘I spoke to clinics who made me feel like they were second-hand car salesmen offering BOGOF deals,’ she says. ‘It didn’t feel right [to be told that] if you book before this date, you’ll get a better deal.

‘To feel you’re being upsold or lining someone’s pockets is a weird situation to be in. I immediately ruled out any clinics that didn’t offer a free consultation or open evening. I didn’t want to pay until I knew what I was paying for.’

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