title: Direct-to-consumer advertising of success rates for medically assisted reproduction: a review of national clinic websites.
abstract: To establish how medically assisted reproduction (MAR) clinics report success rates on their websites.
  
  
  
  Websites of private and NHS clinics offering in vitro fertilisation (IVF) in the UK.
  
  
  
  We identified clinics offering IVF using the Choose a Fertility Clinic facility on the website of the Human Fertilisation and Embryology Authority (HFEA). Of 81 clinics identified, a website could not be found for 2, leaving 79 for inclusion in the analysis.
  
  
  
  Outcome measures reported by clinic websites. The numerator and denominator included in the outcome measure were of interest.
  
  
  
  53 (67%) websites reported their performance using 51 different outcome measures. It was most common to report pregnancy (83% of these clinics) or live birth rates (51%). 31 different ways of reporting pregnancy and 9 different ways of reporting live birth were identified. 11 (21%) reported multiple birth or pregnancy rates. 1 clinic provided information on adverse events. It was usual for clinics to present results without relevant contextual information such as sample size, reporting period, the characteristics of patients and particular details of treatments.
  
  
  
  Many combinations of numerator and denominator are available for the purpose of reporting success rates for MAR. The range of reporting options available to clinics is further increased by the possibility of presenting results for subgroups of patients and for different time periods. Given the status of these websites as advertisements to patients, the risk of selective reporting is considerable. Binding guidance is required to ensure consistent, informative reporting.
authors.affiliation: Centre for Biostatistics, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK.|Research and Development, Salford Royal NHS Foundation Trust, Salford, UK.
authors.forename: Jack
authors.identifier: 0000-0003-3513-4677
authors.initials: J
authors.lastname: Wilkinson
authors.affiliation: Centre for Biostatistics, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK.|Research and Development, Salford Royal NHS Foundation Trust, Salford, UK.
authors.forename: Andy
authors.initials: A
authors.lastname: Vail
authors.affiliation: Centre for Biostatistics, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre (MAHSC), University of Manchester, Manchester, UK.|Central Manchester University Hospital NHS Foundation Trust, Manchester Academic Health Science Centre (MAHSC), Manchester, UK.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Roberts
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D000067088:Direct-to-Consumer Advertising / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D020407:Internet; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate / Q000639:trends*; D011272:Pregnancy, Multiple; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data; D006113:United Kingdom / Q000453:epidemiology
keywords: advertising; assisted reproduction; in vitro fertilisation; live birth rate; success rates