A comprehensive review of IVF add-on treatments has concluded that most of these extra procedures, medicines, or techniques lack reliable evidence of effectiveness and may be a waste of money. The study, published in The Lancet Obstetrics, Gynaecology & Women's Health, found that over 70% of IVF patients in the UK, Australia, and New Zealand pay for at least one add-on during their treatment.
Study details and findings
Researchers from the University of Melbourne analyzed 85 high-quality trials out of 157 potentially eligible studies, excluding 72 due to trustworthiness concerns. They examined 10 common IVF add-ons and found that seven had no effect on fertility or remained inconclusive due to limited or low-quality data.
The seven add-ons with no proven benefit include acupuncture, corticosteroids, endometrial receptivity testing, intralipid infusion, intraovarian injection of platelet-rich plasma, intrauterine infusion of platelet-rich plasma, and pre-implantation genetic testing for aneuploidy.
Weak evidence for some add-ons
Three add-ons showed only weak evidence of possible benefit: EmbryoGlue (an embryo transfer medium) may increase the probability of pregnancy and live birth, but the effect on live birth rates was not robust. Endometrial scratching may also increase the chance of pregnancy and live birth. Physiological intracytoplasmic sperm injection (PICSI) showed weak evidence of lowering the risk of miscarriage.
Expert commentary
Dr. Sarah Lensen of the University of Melbourne stated, "In many countries, infertility care is largely provided by private clinics where IVF is highly commercialised, and some add-ons are extremely expensive. Our review finds a lack of evidence that most of the IVF add-ons we assessed provide any benefit to patients. Unproven add-ons can lead to false hope, greater financial strain and unnecessary medical procedures at what already can be a very difficult time for patients."
Misinformation and clinic practices
Dr. Lensen also highlighted the role of misinformation, noting that "private clinic websites and patient forums on social media often overstate the benefits and omit the costs and risks of add-ons." She urged clinics to carefully consider whether it is appropriate to offer unproven add-ons, as their availability is often perceived as an implicit endorsement of benefit.
