Evidence-based medicine and the role of the National Health Service in assisted reproduction.
The wholesale introduction of any new procedure to medical practice requires an acceptance based on evidence-based medicine, which is primarily acquired using prospective randomized controlled trials. However, for self-funded treatments, as are the majority of IVF cycles, this has always been very difficult to achieve. Generally, new technologies are introduced and adopted by patients who have failed in previous attempts at IVF. Urging patients to enter into a prospective randomized controlled trial is problematic, especially when they are self-funding; eagerness to conceive when time is against them, and/or having undergone previously failed treatment attempts, convince most patients to fund the new technology/opportunity rather than risk falling into the control arm and repeating their previous failure(s). The UK is uniquely placed to advance IVF medicine by helping practitioners and patients gain access to vital trials through the National Health Service.
CARE Fertility Group, John Webster House, 6 Lawrence Drive, Nottingham Business Park, Nottingham NG8 6PZ, UK. Electronic address: simon.fishel@carefertility.com.
Simon
S
Fishel
D019317:Evidence-Based Medicine; D005102:Health Expenditures; D009313:National Health Programs; D016032:Randomized Controlled Trials as Topic; D018456:Reproductive Medicine; D027724:Reproductive Techniques, Assisted / Q000191:economics*; D006113:United Kingdom
IVF; National Health Service; assisted reproduction; evidence-based medicine; randomized controlled trial