MOST ADD-ONS are not proven to benefit patients undergoing IVF, a new systematic review and meta-analysis has found.
In a lot of cases, researchers reported, evidence for the value of add-ons was poor, contributing to uncertainty around effectiveness.
Further, authors had to exclude many studies from analysis due to trustworthiness concerns.
IVF Add-Ons
Over the past decade, IVF add-ons have become increasingly available.
Add-ons are additional procedures, medications, or techniques that aim to boost IVF success rates.
Poor Evidence
Researchers included 85 trials, across 10 systematic reviews and meta-analyses.
Endometrial scratching may be associated with a small increase in the chance of live birth.
However, EmbryoGlue, PGT-A, endometrial receptivity testing, and corticosteroids appeared to have no effect.
For the following add-ons, evidence was unclear due to poor quality or scarcity: physiological intracytoplasmic sperm injection, acupuncture, intralipid, platelet-rich plasma injection into the ovary, and platelet-rich plasma infusion into the uterus.
Tim Child, Chair, Human Fertilisation & Embryology Authority (HFEA) Scientific and Clinical Advances Advisory Committee, London, UK, said: “The findings in these studies match those found in the UK where the HFEA has raised concerns for many years about some clinics offering unproven treatments to patients.
“The HFEA’s add-ons rating system looks at the scientific evidence of add-ons and has also found that most offer no proven benefit to patients, and some can even be harmful.
“For all the treatment add-ons the HFEA has reviewed, none indicate they increase the changes of having a baby for most fertility patients.”
Researchers called for well-designed, large-scale randomised controlled trials to foster reliable evidence on the effect of IVF add-ons.
Child added: “Although, there are cases where treatment add-ons may be offered for reasons other than to improve the chances of having a baby.
“In some circumstances there may be a justifiable reason for using the treatment add-on as part of fertility treatment.”
Reference
Lensen S et al. Safety and effectiveness of ten common in-vitro fertilisation add-ons: a systematic review and meta-analysis. Lancet Obstet Gynaecol Womens Health. 2026;DOI:10.1016/S3050-5038(26)00054-3.
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