{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T17:37:13Z","timestamp":1793381833777,"version":"4.5.0"},"update-to":[{"DOI":"10.12688\/openreseurope.20090.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000}}],"reference-count":24,"publisher":"CERN","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Commission","award":["872706"],"award-info":[{"award-number":["872706"]}],"id":[{"id":"https:\/\/ror.org\/00k4n6c32","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Open Res Europe"],"abstract":"<jats:p>Background\n                    The medically assisted reproduction (MAR) industry is a booming sector of the economy, and Spain is proving to be a notable example of this industry's rise. Marketing strategies in the healthcare sector are shaped by the constant tension between providing clear, complete and appropriate information about treatments and providing information to attract and retain customers.\n                \n                \n                    Methods\n                    We conducted a systematic analysis of success rate information published on the websites of Spain\u2019s five with the strongest online presence MAR clinics as of November 2023. The analysis examined terminology, certifications and audits by external bodies, references to data sources, age-specific success rates, and generalised claims about treatment effectiveness.\n                \n                \n                    Results\n                    We identified significant deficiencies and ambiguities in how clinics present success rate data. Common issues included vague definitions, lack of certification details, absence of reliable data sources, and failure to differentiate outcomes by age or treatment type. Several clinics used overly optimistic or potentially misleading statistics, making it difficult for patients to assess their realistic chances of success. We provide recommendations aimed at improving consumer protection and regulating  advertising practices. We also emphasise that presenting clear and truthful success rate information is not only a legal requirement but also an ethical duty in reproductive healthcare.\n                \n                \n                    Conclusions\n                    Stronger regulation of success rate reporting in Spain\u2019s fertility sector is urgently needed. We recommend that external authorities oversee and standardise data reporting to ensure transparency and prevent misleading practices. A centralised public body should be responsible for monitoring, collecting, and managing this data to protect patient rights and improve trust in fertility care.<\/jats:p>","DOI":"10.12688\/openreseurope.20090.2","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T09:50:05Z","timestamp":1761126605000},"update-policy":"https:\/\/doi.org\/10.68336\/openreseurope.updatepolicy","source":"Crossref","is-referenced-by-count":0,"title":["Analysis of online information about success rates in fertility clinics in Spain. An urgent call for action"],"prefix":"10.68336","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7952-7731","authenticated-orcid":true,"given":"Anna","family":"De Bayas Sanchez","sequence":"first","affiliation":[{"name":"Institute for Medical Humanities, First Medical Faculty, Charles University, Prague, Czech Republic"},{"name":"Medistella, Mediversvm s.r.o., Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginie","family":"Roz\u00e9e","sequence":"additional","affiliation":[{"name":"INED, Research Unit \u201cSexual and reproductive Health and Rights\", Aubervilliers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manon","family":"Vialle","sequence":"additional","affiliation":[{"name":"INED, Research Unit \u201cSexual and reproductive Health and Rights\", Aubervilliers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1062-7918","authenticated-orcid":true,"given":"Kristien","family":"Hens","sequence":"additional","affiliation":[{"name":"Department of Philosophy, University of Antwerpen, Antwerpen, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1423-2545","authenticated-orcid":true,"given":"Joke","family":"Stryuf","sequence":"additional","affiliation":[{"name":"Department of Philosophy, University of Antwerpen, Antwerpen, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willem","family":"Ombelet","sequence":"additional","affiliation":[{"name":"The Walking Egg Non-Profit Organization, Genk, Belgium"},{"name":"Faculty of Medicine and Life Sciences, University of Hasselt, LCRC, Diepenbeek, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Rosa","family":"Tapia S\u00e1nchez","sequence":"additional","affiliation":[{"name":"University Rey Juan Carlos, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8805-0680","authenticated-orcid":true,"given":"Marta Mar\u00eda","family":"Albert M\u00e1rquez","sequence":"additional","affiliation":[{"name":"University Rey Juan Carlos, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4831-5541","authenticated-orcid":true,"given":"Juana","family":"Farf\u00e1n Montero","sequence":"additional","affiliation":[{"name":"University Rey Juan Carlos, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3847-8312","authenticated-orcid":true,"given":"Jos\u00e9 Miguel","family":"Carrasco","sequence":"additional","affiliation":[{"name":"APLICA Investigaci\u00f3n y Traslaci\u00f3n Cooperative, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Fuller","sequence":"additional","affiliation":[{"name":"Medistella, Mediversvm s.r.o., Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0410-1645","authenticated-orcid":true,"given":"Vera","family":"Dimitrievska","sequence":"additional","affiliation":[{"name":"University of American College, Skopje, North Macedonia"},{"name":"Healthgrouper, North Macedonia, North Macedonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana","family":"Melosca","sequence":"additional","affiliation":[{"name":"Healthgrouper, North Macedonia, North Macedonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel","family":"Barrett","sequence":"additional","affiliation":[{"name":"Institute for Culture and Society, University of Navarra, Navarra, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"G\u00fcell Pelayo","sequence":"additional","affiliation":[{"name":"Institute for Culture and Society, University of Navarra, Navarra, Spain"},{"name":"Facultad de Bio\u00e9tica, Universidad An\u00e1huac M\u00e9xico, Ciudad de M\u00e9xico, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"13904","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"82383","unstructured":"Agence de la biom\u00e9decine: Principaux chiffres de l\u2019activit\u00e9. [Access 1 Oct 2024]. Reference Source (https:\/\/rams.agence-biomedecine.fr\/principaux-chiffres-de-lactivite)"},{"key":"82384","unstructured":"Carrasco MJ, et al.: B2-InF project repository. Zenodo. 2023. Reference Source (https:\/\/zenodo.org\/communities\/b2inf_h2020\/)"},{"key":"82385","unstructured":"Centers for Disease Control and Prevention (CDC): IVF success estimator. [Accessed 14 Jan 2024]. Reference Source (https:\/\/www.cdc.gov\/art\/ivf-success-estimator\/)"},{"key":"82386","unstructured":"Committee of Advertising Practice: Enforcement notice: advertising of fertility treatments. Advertising standards authority,2021. Reference Source (https:\/\/www.google.com\/url?sa=t&source=web&rct=j&opi=89978449&url=https:\/\/www.asa.org.uk\/static\/cb6c3d82-5bfc-463a-9a9fac5cbfe6d831\/f00db49e-0bde-4ccf-940807410ace35d9\/Fertility-Treatments-Enforcement-Notice-FINALPDF.pdf&ved=2ahUKEwiDjbSk8K6NAxV2SGcHHUDKJpAQFnoECA8QAQ&usg=AOvVaw1QtWenKeCEZCIsNlHSsEeJ)"},{"key":"82387","doi-asserted-by":"publisher","DOI":"10.1016\/j.xfnr.2021.09.004"},{"key":"82388","unstructured":"European Union: Directive 2006\/114\/EC of the European Parliament and of the council of 12 December 2006 concerning misleading and comparative advertising. Official Journal of the European Union (OJ). L376, 27 December2006; Art. 3. Reference Source (https:\/\/eur-lex.europa.eu\/legal-content\/EN\/TXT\/PDF\/?uri=CELEX:32006L0114)"},{"key":"82389","unstructured":"Fertility Society of Australia and New Zealand (FSANZ): ANZARD: assisted reproductive technology in Australia and New Zealand. Fertility Society of Australia and New Zealand. Reference Source (https:\/\/www.fertilitysociety.com.au\/art-regulation\/anzard\/)"},{"key":"82390","unstructured":"International Chamber of Commerce (ICC): Code of advertising and marketing communication practice. Paris: ICC, 2018. Reference Source (https:\/\/iccwbo.org\/wp-content\/uploads\/sites\/3\/2018\/09\/icc-advertising-and-marketing-communications-code-int.pdf)"},{"key":"82391","doi-asserted-by":"publisher","DOI":"10.1111\/1467-9566.13590"},{"key":"82392","doi-asserted-by":"publisher","DOI":"10.1007\/s11294-019-09732-9"},{"key":"82393","unstructured":"Precedence Research: Fertility market size, growth, trends and report, 2023 to 2032. Precedence Research, [Accessed 12 Oct 2023]. Reference Source (https:\/\/www.precedenceresearch.com\/fertility-market)"},{"key":"82394","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2021.08.012"},{"key":"82395","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2020.07.001"},{"key":"82396","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2025.05.150"},{"key":"82397","unstructured":"Sociedad Espa\u00f1ola de Fertilidad (SEF): Registro nacional de Actividad - Registro SEF. 2021. Reference Source (https:\/\/www.registrosef.com\/public\/docs\/sef2021_IAFIV.pdf)"},{"key":"82398","unstructured":"Sociedad Espa\u00f1ola de Fertilidad (SEF): Registro Nacional de Actividad Registro SEF. Informe estad\u00edstico de t\u00e9cnicas de reproducci\u00f3n asistida,2022. Reference Source (https:\/\/www.registrosef.com\/public\/docs\/sef2022_IAFIV.pdf)"},{"key":"82399","unstructured":"Society for Assisted Reproductive Technology (SART): IVF success estimator. [Accessed 3 Feb 2025]. Reference Source (https:\/\/sartcorsonline.com\/Predictor\/PatientV2Input)"},{"key":"82400","unstructured":"Spain: Law 34\/1988, of 11 November, General Advertising \u2013 updated on 1 March 2023. Bolet\u00edn Oficial del Estado (BOE), No. 274, 15 November1988; Art. 3. Reference Source (https:\/\/www.g-regs.com\/downloads\/SPGenAdvertisingLaw3419882022EN.pdf)"},{"key":"82401","unstructured":"Spain: Law 3\/1991, of 10 January, on unfair competition. Bolet\u00edn Oficial del Estado (BOE), No. 10, 11 January1991; Art. 7.1. Reference Source (https:\/\/www.g-regs.com\/downloads\/SPUnfairCompLaw3_1991.pdf)"},{"key":"82402","unstructured":"Spain: Law 14\/2006, of 26 May: on techniques of human reproduction. Bolet\u00edn Oficial del Estado (BOE), No. 126, 27 May, 2006; Art. 3.1. Reference Source (https:\/\/www.boe.es\/buscar\/act.php?id=BOE-A-2006-9292)"},{"key":"82403","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-012218"},{"key":"82404","doi-asserted-by":"publisher","DOI":"10.1097\/GRH.0000000000000052"},{"key":"82405","doi-asserted-by":"publisher","DOI":"10.1093\/hropen\/hoac022"},{"key":"82406","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlpt.2024.100842"}],"container-title":["Open Research Europe"],"original-title":[],"link":[{"URL":"https:\/\/open-research-europe.ec.europa.eu\/articles\/5-159\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/ore.eu\/ore\/article\/download\/957\/version\/1663\/3323","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/ore.eu\/ore\/article\/download\/957\/version\/1663\/3324","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/ore.eu\/ore\/article\/download\/957\/version\/1663\/3323","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T17:13:09Z","timestamp":1793380389000},"score":1,"resource":{"primary":{"URL":"https:\/\/ore.eu\/ore\/article\/view\/957\/version\/1663"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,22]]},"references-count":24,"URL":"https:\/\/doi.org\/10.12688\/openreseurope.20090.2","relation":{"is-version-of":[{"id-type":"doi","id":"10.12688\/openreseurope.20090.1","asserted-by":"subject"}],"has-review":[{"id-type":"doi","id":"10.21956\/openreseurope.23336.r64194","asserted-by":"object"}]},"ISSN":["2732-5121"],"issn-type":[{"value":"2732-5121","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,22]]},"assertion":[{"value":"2025-10-22","name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}},{"value":"This project has received funding from the European Union\u2019s Horizon 2020 research and innovation programme (Be Better Informed about Fertility [B2-InF]).\n\n                    The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","name":"funding_statement","label":"Funding Statement","group":{"name":"funding_information","label":"Funding Information"}}],"article-number":"159"}}