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Have a baby at new low, low price, says fertility doctor Joel Batzofin

Rating

2 Star

Have a baby at new low, low price, says fertility doctor Joel Batzofin

Our Review Summary

Is cheap really the whole story? This piece focuses on a novel infertility or subfertility treatment that is still an active subject of active research in the biomedical research community. It provides little data and little balanced expert comment.  Also, there is NO evidence that anyone has data that directly compares IVF and IVM, let alone understands cost per cycle, conception, or healthy pregnancy.

The story does note that IVM (in vitro maturation) treatments are not widely available and this method is not as successful or widely accepted in the medical community as IVF (in vitro fertilization) treatments, and that Dr. Batzofin is one of the first doctors in Manhattan to offer the treatments while simultaneously conducting a clinical trial on IVM. Dr. Batzofin discusses his own “number needed to treat” in order to consider IVM a success (20 to one pregnancy), however, this seems arbitrary.  There is no sense of valid expected outcomes from data. Doing this story when even the outcomes of the first three transfers is unknown is showmanship not reporting.

The story makes a simple comparison of IVF v. IVM for the lay reader, but does not discuss risks for women with and without polycystic ovarian syndrome (PCOs).  Other methods to increase fertility are not discussed.  The story does compare average costs of one course of IVF treatments with one course of IVM treatments.  But given the lack of proven success with IVM, multiple rounds of treatments may be necessary to conceive.  This is not specifically stated and the focus of the story, a promotion of IVM (and Dr. Batzofin’s clinic) as a more cost-effective method of fertility treatments is misplaced.

The story mentions that IVM has been studied in some clinical trials in Denmark and Canada; results have been mixed and mostly included younger women, who would have an easier time conceiving.  We are not told if these are randomized clinical trials. There are no data presented from these trials.

Lastly, the story does not do a good job finding unbiased sources to speak to the difference between IVF and IVM treatments–only one person is cited. An additional researcher or fertility expert could provide a balanced review of the current evidence (both benefits and harms of IVM for PCO and non-PCO women) and discuss less dramatic first-line  treatments to enhance fertility. The story does interview women who serve mainly to promote Dr. Batzofin’s clinic.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story does compare average costs of one course of IVF treatments with one course of IVM treatments. Given the lack of proven success with IVM, multiple rounds of treatments may be necessary to conceive.  This is not specifically stated and the focus of the story is promoting IVM as a more cost-effective method of fertility treatments. This emphasis is misplaced. 

There NO evidence that anyone has data that directly compares IVF and IVM, let alone understands cost per cycle, conception, or healthy pregnancy.

 

Kathie, confused here and not sure if we should ding given that they did list the cost of each treatment? 

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

Dr. Batzofin discusses his own "numbr needed to treat" in order to consider IVM a success (20 to one pregnancy), however, this seems arbitrary. The story should include the typical success rate of IVM compared with IVF and with other fertility treatment methods.  There is no sense of valid expected outcomes from data. Doing this story when even the outcomes of the first three transfers is unknown is showmanship not reporting.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

The story does not adequately list the harms of this treatment for women with and without polycystic ovarian syndrome (PCO). Instead the story focuses on the potential downsides of IVF and the risks of hormones for some women.

The target group, that is, women with subfertility, can enhance their likelihood of conceiving with modest weight loss and conventional medications as needed, but who might be lured into this "tennis shoe" treatment out of fear that they won’t conceive rather than doing the harder thing of diet, activity, and physical activity. This is not dicussed. However, IVM requires egg retrieval and embryo transfer, the same as IVF, and these risks should be mentioned– the former with small risks of bleeding and infection and the latter with small risk of infection and poorer reproductive outcomes.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The story mentions that IVM has been studied in some clinical trials in Denmark and Canada and that results have been mixed and mostly included younger women, who would have an easier time conceiving .  There are no data presented from these trials. In a Pubmed search for these and other studies on the topic of IVM, it appears there are still no RCTs comparing IVM v. IVF, and information is inadequate to understand differences.

The story does note that the treatment is new and Dr. Batzofin is conducting his own clinical trial. We are not told of the design of this trial nor who is funding.

Does the story commit disease-mongering?

Not Satisfactory

The story inappropriately describes women with polycystic ovarian syndrome (PCO) as those "who don’t produce mature eggs and can get sick on fertility drugs."  As a sweeping statement it is way off the mark and given the focus in the scientific literature about IVM is on this subfertile group, it is an exagerration.

In a British study that is a good example of reproductive epidemiology (Clayton RN, Clin Endocrin 1992) that systematically screened 353 women with ultrasound for PCO they found: Proven prior fertility was the same in PCO (56%) and non-PCO (64%) women and an equal proportion in each group had not yet tested their fertility. Of those women with previously proven fertility, self-perceived difficulty in conception occurred in similar proportions of women with and without PCO. Unresolved primary or secondary infertility (2.5-4%) was similar in both groups.

The prevalence of PCO in the general population and in infertility treatment populations don’t match – it is a biased sample that are referred – and the outcomes are not comparable. A number of trials have shown metformin and clomiphene citrate (both pills) to enhance conception in women with PCO and metabolic syndrome. These drugs do not cause ovarian hyperstimulation and thus would be general gynecology treatments used far before IVF (or IVM with IVF).

 

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

The story does not do a good job finding unbiased sources to speak to the difference between IVF and IVM treatments–only one person is cited. An additional  researcher or fertility expert could provide a balanced review of the evidence (both benefits and harms) of these and additional fertility treatments, which might also be appropriate for women who cannot take hormones typical of IVF regimens.  The story does interview women who serve mainly to promote Dr. Batzofin’s clinic.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story focuses on a comparison of IVF v. IVM.  Other methods to increase fertility are not discussed.  Women with subfertility and PCO may try less dramatic means to enhance their likelihood of conceiving with modest weight loss and conventional medications as needed. 

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The story notes that IVM (in vitro maturation) treatments are not widely available and this method is not as successful or widely accepted in the medical community as IVF (in vitro fertization) treatments.  The story notes that Dr. Batzofin is one of the first doctors in Manhattan to offer the treatments and is conducting a clincal trial on IVM. 

Does the story establish the true novelty of the approach?

Satisfactory

The focus of the story is IVM as a newer method of fertility treatment.  The story is clear that there have not been many births from this method.

Does the story appear to rely solely or largely on a news release?

Not Applicable

We can’t be sure if this story is based on information from a press release.

Total Score: 2 of 9 Satisfactory

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