This paper highlights a crucial fault in the provision of assisted reproductive technology (ART) in Australia.

In failing to provide accurate information to women and the community on their websites, clinics are failing women and men as they try to start a family. While pregnancy features in clinic advertising and babies' images are displayed in clinic waiting room as decorations, women struggle to work out whether they should start ART, continue ART or stop ART - all the while paying handsomely. 

It's time for clinics to get focused on attending to women's rights to informed choice, trust and supported care, and for regulatory bodies to step up and ensure transparency, consistency and accountability to the community.

The definitions of the parameters used in this study are unclear. It is very hard to understand what has been measured and in what context, making the review non-transparent and subjective.

The eight parameters are also limited in their assessment of websites - there is much additional information which wasn't considered. Websites are only part of the information base provided to patients. Much information is also provided at doctor and clinic level.

Reviewing the most recent annual report from VARTA, the organisation from which this study emanates, and applying their eight criteria indicates a score of five, i.e. no better than the average clinic website.

Additionally, the parameters in the study were not those which the ACCC was mainly concerned. The ACCC was concerned about misleading information on clinic websites, and this area was not addressed in the study. I am aware of many clinics who have withdrawn or rewritten their websites.

The Fertility Society of Australia guidelines on public information have been incorporated as part of the latest revision of the Reproductive Technology Accreditation Committee code of practice, and so will be part of the licensing process.

Many of the issues around public information will also be addressed in the near future by changes to the Australian & New Zealand Assisted Reproduction Database, which will enhance patient access to real-time IVF data.

Patients rely very much on websites to get medical information and this is particularly true when they are looking at chronic illnesses, which may include infertility. In a very competitive commercial market, IVF clinics are seeking to attract patients who may require IVF and, accordingly, are using multiple methods of advertising and sharing of information with potential clients.
 
This paper looks at the use of websites by IVF clinics in Australia with particular emphasis on pregnancy rates, which appear to be the main discerning factor searched for by patients who may need fertility treatment. The authors have shown that a large number of websites do not provide even basic information about the prospects of a baby being born healthy and alive and that this has not improved since regulatory threats were made by the ACCC.
 
It is clear that a standard reporting mechanism should be instituted that allows people to compare between clinics undergoing the same procedure, prospectively before egg recovery occurs. This is the process that occurs in the USA and UK. The birth of a live and healthy baby should be the end point rather than a positive pregnancy test. An independent body should audit the results published on websites.
 
Another problem with website pregnancy information is that it does not reflect those patients who become pregnant with simpler methods that do not incorporate IVF. For instance, a clinic may get 50 per cent of its patients pregnant without IVF and then run 30 per cent pregnancy rates with IVF. This may contrast with a clinic that gets 0 per cent of its patients pregnant without IVF and runs a 40 per cent pregnancy rate with IVF. I would maintain that the former clinic is better than the latter and yet this will not be reflected on a clinic's website unless more consistent information is provided.

Research supports that couples and singles seeking information about fertility care are likely to use the internet as a source of information.

In November 2016, the ACCC made a statement saying it ‘expects that all IVF clinics will take care to ensure that success- rate comparisons are clear and accurate, and based on data that is explained in non- technical terms so that consumers can rely on it to make informed choices about which IVF clinic to use’.

In this study, researchers obtained publically available data from the websites of Australian IVF clinics, much like a patient may attempt to seek information when considering starting fertility treatment. They characterised the quality of information, and compared the information to that of the previous year, prior to the ACCC report and statement.

Concerningly, researchers report only a small, and non-significant improvement, implying no major changes to information availability for consumers has occurred as a result of the ACCC Report.

Most alarmingly, only half the websites report success as a healthy baby; the sole reason couples seek fertility care.

This research raises a strong argument for improving transparency and availability of information for patients seeking information about their health and fertility care.