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Year : 2021  |  Volume : 8  |  Issue : 2  |  Page : 122-127

Intermediary step − a double-blind sword

Queen’s Hospital, Rom Valley Way, Romford, Essex, UK

Correspondence Address:
Dr. Jayant G Mehta
Queen’s Hospital, Rom Valley Way, Romford, Essex RM7 0AG
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/fsr.fsr_43_21

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To improve the clinical pregnancy rate, the in vitro fertilization clinics worldwide have ignored the “ethical and cardinal” restrain by offering scientifically unproven safe treatments for their patients and possibly compromising the unborn child’s health. Human fertilization and embryology authority requires all their licensed clinics to take into account the welfare of the unborn child and guides clinics and patients. They have instituted a traffic light monitoring system for various intermediary steps currently offered by the clinics. This review discusses the value of the scientific evidence available against the safety of the patients and the unborn child against the extra cost implications for utilizing these intermediary steps. Those in the red category should not be used as there is insufficient good-quality evidence for these steps. Those in the yellow, while having good quality evidence, require additional evidence before they are considered safe. The steps in the green category only have proven their safety by establishing good quality evidence. The intermediary steps discussed include: oocyte activation, use of time-lapse systems, need for hatching, use of hyaluronic acid, routine assessment of sperm DNA fragmentation, and use of advanced sperm selection techniques. The author offers his interpretation of the evidence and concludes by questioning the acceptability of using these intermediary steps routinely.

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