This year’s Nobel Prize in Medicine went to Robert Edwards, a UK physiologist who, over 30 years ago, developed the technique for in-vitro fertilization (IVF). Since then, IVF has become an enourmous industry. An individual cycle of IVF can cost $10-15,000 but the average chance of success is roughly 1 in 5 (varying widely according to many factors). Therefore, any improvements in the technique to improve the success rate is welcome news to potential parents.
This story reports on a new technique that entails observing the embryo divide and develop to attempt to predict which ones would have the highest chance of success. While this method may be truly an advancement in IVF technology, this story does little to educate readers on its potential importance. It provides inadequate information about the availability, costs and potential harms of IVF. It does not discuss the strength of the evidence to support the new technique nor does it describe the success rates of the procedure compared to existing methods. The story does not quote any independent sources that could have provided some perspective on the importance of the results, which is sorely missing from this story. Most distressing, the story exagerrates the perils of pregnancy by providing such scary statistics as the 50% miscarriage rate. In doing so, it overstates the need for reproductive assistance technologies, including IVF.
In the end, this story appears to be little more than a thinly-veiled advertisement for IVF, an industry which is in little need of help.
Couples who seek to have children using IVF face high costs and frequent failures. Stories on this topic must tread carefully to not raise unwarranted hopes.
The story makes no mention of costs of IVF, other than to point out the total revenues of the IVF industry. There is no estimate of the possible costs of (or even savings from) adding this test to standard IVF.
The story suggests this test would benefit couples by reducing the number of IVF attempts needed to have a baby or by reducing the risk of multiple births. However, the researchers have not even begun to explore those outcomes. The story should have made more clear that in fact the research is too preliminary to for anyone to guess at whether or not it might improve either birth rates, reduce the typical number of embryos implanted or otherwise improve the IVF experience.
The story mentions no potential harms of the new IVF method. Readers are not told whether the test itself could damage the embryo.
The story provides few details about the study. It refers the "fate" of the embryos without pointing out that this experiment did not go beyond the blastocyst stage. The story would have been better if it clearly pointed out that this work was done entirely in lab dishes and that none of the embryos was implanted, so there is not yet any evidence about the ultimate outcome that readers care about: live births.
The story exagerrates the perils of pregnancy by providing such scary statistics as the 50% miscarriage rate. In doing so, it overstates the need for reproductive assistance technologies, including IVF. Further, it misstates the recommendations about multiple embryo transfer. Twin transfers are common and not always "born to early and face lifelong health problems." Guidelines suggest transferring number of embryos not likely to result in higher order than twins. This is often three but can be more embryos based on maternal age, prior loss record, egg quality, and other genetic testing/observation of the likely viability of the embryos.
The story notes that the researchers are licensing development of a commercial test. However, it does not quote any independent sources. Only the CEO of the IVF company and a study author are quoted. Independent sources could provide some perspective on the importance of the results, which is sorely missing from this story.
The story mentions conventional IVF and "the old fashioned way" but does not provide any real content on the pros and cons of the different methods. There are many choices for reproductive assistance but the story doesn’t describe any of them.
While the story suggests that this new IVF method is new and the results are preliminary, it does not indicate when the method may become available or how widely. Indeed, the story does not make clear that the researchers have yet to attempt clinical trials and do not have any data about development beyond the blastocyst stage (which is only vaguely described), readers may be led to believe that clinical use is nearer than it probably is.
This method of evaluating embryos may be new, but since the story does not mention any alternative approaches nor any comments from idependent experts it is impossible for readers to know how this work compares to either current practice or other methods under development.
There is no way to know if the story relied on a press release as the sole source of information.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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