Intended for healthcare professionals

Rapid response to:


Are we overusing IVF?

BMJ 2014; 348 doi: (Published 28 January 2014) Cite this as: BMJ 2014;348:g252

Rapid Response:

Re: Are we overusing IVF?

In the last 12 months my husband and I found ourselves requiring investigation for sub-fertility and for me I personally felt IVF was often offered to easily and too soon.

Couples suffering with sub-fertility are often in significant emotional distress with their situation. We live in a culture where pregnancy is something we can avoid, we are taught in school that even one act of unprotected indiscretion can lead to pregnancy but we are not made aware that when we do decide we want a child we may not fall pregnant immediately. This expectation from the couple, their family and friends adds a huge amount of pressure to the process of trying to conceive. When we fail to conceive within our, or the medical professions, expected timeframe we turn to fertility investigations.

My personal experience of investigation for sub-fertility was far from what I expected. I was shocked when after a pelvic ultrasound, swabs and a few blood tests I was offered IVF as first line. We had been trying for over 2 years, but all our investigations had been normal. I personally felt a procedure as invasive as IVF should be a ‘last resort’. I was told I would need to start the procedure within the next 2-3 months or risk losing funding. I was left with a very difficult decision – to postpone intervention and risk losing my ‘last resort’ treatment, or go ahead with a risky procedure despite my reservations. The clinic did nothing but encourage me to go ahead, especially considering the excellent success rates (over 50%) with women under 30 with unexplained infertility. After careful consideration my husband and I decided not to proceed with IVF despite our very real fear of never being able to have a child.

My husband and I were lucky to find ourselves pregnant 6 months later, with no help to conceive. For many couples it is too much of a gamble to wait and see. Trying to conceive becomes the focus of life, altering plans for holidays, for travel, for change of employment. Along with ensuring the safety and efficacy of IVF we should consider the need for education for couples preparing to conceive, and for the wider population, to reduce the emotional burden and social stigma for those who do go on to have sub-fertility and ensure balanced information is given in fertility clinics to these couples.

Competing interests: No competing interests

31 January 2014
Angela Nelmes
University Hospital of North Staffordshire
351 Hartshill Road, Stoke on Trent, Staffordshire. ST4 7NR