TV Review – Miracle Mums

Assisted reproductive treatment is high stakes. What are the consequences if things go wrong and the resulting harm might have been preventable? 'Miracle Mums' tells the story of a couple affected by inaccurate genetic testing of their embryos and an associated class action against one of Australia's biggest fertility clinic chains, which offered the testing.

'7NEWS Spotlight' is an Australian commercial TV programme that focuses on current affairs and 'long-form investigations of national significance' (7Plus, 2022). A segment entitled 'Miracle Mums' recently followed Laura and Suzie, a same-sex couple who sought assisted reproductive treatment to start their family. Each underwent IVF and, after several rounds of failed treatment, became pregnant at the same time, giving birth within days of each other.

Despite their ultimate 'miracle', Laura and Suzie are among about 200 people who have joined a class action against one of Australia's largest fertility clinic companies, Monash IVF Group. Complainants in this action are claiming that they experienced harm as a result of preimplantation genetic testing (PGT) of embryos offered by the firm. Problems with the test meant that some embryos were incorrectly deemed non-viable, and some of these were reportedly destroyed.

Although we do not yet have a detailed account of the clinical data relied upon by Monash IVF, claims have been made that its offer of non-invasive embryo testing for aneuploidy (niPGT-A), as an alternative to the 'invasive' method via embryo biopsy (PGT-A), was based on poor quality trial data and against the consensus of the scientific literature at the time. Complainants are also claiming that they were not adequately informed about the limitations of the test.

In addition to putting a human face to events covered by the class action proceedings, the Spotlight programme offers an affecting visual exploration of the emotional and physical ups and downs of IVF. Interviews with the couple and the class action lawyer are interwoven with personal 'home videos' recorded by the couple throughout their treatment journey. We see them undergoing procedures, reacting to pregnancy test results and, most poignantly, responding to the news about inaccurate embryo testing.

These vignettes offer a compressed yet coherent insight into the experience of IVF treatment as a long, emotional and exhausting process. Early in her journey, Laura reflects jovially on her confidence and excitement: 'how good is science'. Later, we see Laura sitting in a hospital bed: 'It's very extreme. Very extreme,' she says of IVF.

The use of emotive editing and production is striking, but not surprising given the platform. We are first introduced to Suzie, a professional theatre performer, as she sings the lament 'I dreamed a dream' (from the musical Les Misérables) in an empty hall of the Sydney Opera House. Here, and at some other points, the production feels overly dramatised at the expense of conveying the harms it seeks to depict. Nevertheless, it takes the viewer on a compelling emotional journey reflective of the subjects' experience of IVF.

Laura and Suzie make it clear that they want to be represented, in part to tell their story and, in part (as they note) to normalise same-sex relationships. The programme does this well, while depicting the real impacts of the class action events, but it also risks contributing to an overrepresentation of IVF success stories, in stark contrast to common reality of treatment failure for many.

Given that the class action is still underway, the story lacks details of the events that led up to the action and appropriately avoids explicitly attributing responsibility. Monash IVF declined interview, so the story also does not offer the perspective of the providers and clinicians involved in offering the test. Reporting the story at this early stage and without the clinic's perspective could be viewed as somewhat irresponsible, as it is likely that, as they emerge, the details of the case and the perspectives of the provider will show just how complex medical innovation can be.

As information about the case emerges, it will be important to reflect on a number of questions, including how research data is collected and appraised, what types and levels of evidence are required before interventions are introduced into routine practice, what consent is necessary for diagnostic and screening tests, who is responsible when things go wrong and, how they should be held to account.

The case also raises questions about commercial pressures on medical practice and responsible clinical innovation in a highly competitive industry. Here, the non-invasive embryo testing was offered as an 'add-on' treatment at additional cost to patients, and allegedly represented as the 'gold standard' of testing for embryo viability.

For those looking for an in-depth exploration of the underlying issues of responsibility and the role of regulation in this space, this programme is a boiled sweet, not a roast dinner. Having said this, as a commercial current affairs news programme, it tells its human-interest story well, seemingly accurately and with a sensitivity not always typical of the genre. As details of what happened at Monash IVF Group become clearer, we must have a meaningful discussion about what the case means for innovation, consent and responsibility in assisted reproductive technology and in medicine more generally.