INFERTILE patients who spend thousands of pounds trying for a baby are risking exploitation because they fail to treat IVF as a business transaction, an expert on the economics of reproductive medicine cautioned yesterday.

People seeking private fertility treatment need to recognise that they are consumers as well as patients and to guard against paying vast sums for procedures with little chance of success, according to Debora Spar, of Harvard Business School.

The desperation of infertile patients to start a family has created a “perfect market” for the £500 billion-a-year IVF industry, whose customers are willing to try expensive procedures again and again, even though they fail more than two thirds of the time.

This leaves patients vulnerable to the “inherent conflict” of doctors who advise on medical needs and profit from the diagnostic tests and treatments that they prescribe, Professor Spar said.

More than 70 per cent of IVF in Britain is conducted by private clinics, which generally charge between £2,500 and £4,000 for a single cycle of treatment that has an average success rate of 28 per cent for women under the age of 35.

Additional tests, drugs and embryo screening can push the price as high as £10,000 a cycle, with significantly lower success rates for older women.

Despite the steep costs involved, neither fertility specialists nor their patients like to acknowledge that private IVF is a branch of business as well as of medicine, said Professor Spar, who analysed the American IVF market in her recent book, The Baby Business.

“We tend to deal with infertile patients from a human perspective,” she said. “But they are also consumers, yet they don’t act like consumers. The patients see themselves as parents creating a child, not purchasing one.

“We need to get rid of sentimentality and acknowledge the commercial nature of the transaction, to protect patients and also the children that might emerge as a result. When people are in this market they tend not to behave like rational consumers.”

Professor Spar, who will address the Human Fertilisation and Embryology Authority conference in London today, said that too few clinics gave full information about the likely costs and outcome of their treatment. The authority’s remit should be expanded to allow it to regulate financial aspects of IVF, to prevent the therapy becoming available primarily to the very wealthy.

“We could see it as just a luxury market like high-end jewellery, where, as long as there is no fraud, it is a matter of . . . if you can pay for it, you get it.”

Patients needed to be told more about the costs and success rates but could also protect themselves by taking a more hard-headed approach and asking sceptical questions about value for money.

“In the private market in the UK there is not a lot of information about what the final costs are going to be, which is problematic. Because there is no regulation, patients are in a very vulnerable position, particularly as the situation feels medical not commercial.

“We have to acknowledge that we have created a baby business, to move away from emotion and towards thinking rationally. It sounds coldhearted, but it’s actually more humane for the patients to see the commercial elements of the transaction, rather than to see it purely in emotional terms.”

Infertile patients need particular protection, often being willing to go to extreme lengths and to suspend rational judgments that they would make when buying a computer or holiday. “From a market perspective this is terrific — people are looking for a product for which they will do virtually anything.

“Patients have a slightly incestuous relationship with providers. There is an incentive to keep asking patients to have techniques that are not going to work, and patients press them to keep going. There’s an inherent conflict here. Doctors are in a position where they don’t have anything to stop them from providing treatment again and again, regardless of whether it is going to work.”

Her remarks come a week after the General Medical Council cleared Ian Craft, of the London Fertility Centre, of serious professional misconduct. He had been accused of charging inflated fees for unnecessary procedures.

The Government is reviewing Britain’s fertility laws, which were framed in 1990 and are regarded as out of date. The authority has suggested that patients be given a costed treatment plan before therapy. Professor Spar said: “If we don’t regulate, we will go further towards the private market. It means, in the extreme, that rich infertile people will be able to reproduce and poor infertile people will be left childless.”

BABY BLUES

About 20 per cent of IVF births are twins, and 0.5 per cent triplets. Clinics are now banned from transferring more than two embryos to a womb, except in exceptional circumstances

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