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Fads and foibles in ART: Where is the evidence?

This commentary on the scientific basis of laboratory procedures in assisted conception discusses the origins of widespread discrepancies in ‘standard’ laboratory techniques experienced by patients and their embryos. The lack of direct evidence from clinical laboratory trials and the reasons for this will be highlighted using some examples drawn mainly from embryo culture. Inconsistencies and grey areas in the governance framework of this unique field could usefully be eliminated and attention focused on the need for a rational approach to procedural trials and pilot studies necessarily conducted in clinical laboratories. This may help progress towards a consensus on fundamental questions for which the evidence is currently lacking.