Costly IVF add-ons fail to show benefits, new study finds
A range of extra treatments marketed by fertility clinics to improve the chances of success during in vitro fertilisation (IVF) lacks convincing evidence that they work, according to a new study published in the scientific journal The Lancet.
The study examined 85 clinical trials assessing so-called IVF “add-ons” — additional procedures, tests and medicines offered alongside standard fertility treatment, often at significant cost to patients. Researchers found that most provide little or no proven benefit, despite being widely promoted by private clinics.
“There is widespread misinformation about IVF add-ons, with private clinic websites and patient forums on social media — major information sources for patients — often overstating the benefits and omitting the costs and risks,” Sarah Lensen, study author and researcher at the University of Melbourne said.
The review found that seven of 10 widely used add-ons either had no measurable effect on fertility outcomes or were supported only by limited, low-quality evidence.
These included acupuncture, medication to reduce inflammation, a biopsy of the uterine lining to assess gene expression patterns, soybean oil and egg yolk that is administered into the blood and platelet-rich plasma treatments administered either to the ovaries or the uterus.
Researchers also found insufficient evidence to support the use of pre-implantation genetic testing for aneuploidy (PGT-A), a screening technique used to check embryos for chromosomal abnormalities before transfer.
Only three add-ons showed any potential benefit, though the evidence remained weak.
EmbryoGlue, a transfer medium containing hyaluronic acid designed to aid embryo implantation in the uterus, may increase the likelihood of pregnancy and live birth, although researchers said the findings on live birth rates were not robust.
Endometrial scratching, a procedure that deliberately disrupts the lining of the womb before embryo transfer, was also associated with a possible increase in pregnancy and live birth rates.
Meanwhile, physiological intracytoplasmic sperm injection (PICSI), a sperm-selection technique designed to identify more mature sperm, showed weak evidence of reducing the risk of miscarriage.
“Unproven add-ons can lead to false hope, greater financial strain and unnecessary medical procedures at what is already a very difficult time for patients,” Lensen said.
“IVF clinics and clinicians should carefully consider whether it is appropriate to offer unproven add-ons, as their availability is often perceived by patients as implicit endorsement of benefit.”
Despite the lack of evidence supporting many of these treatments, their use remains widespread. More than 70% of IVF patients in Australia, New Zealand and the United Kingdom report using at least one add-on during treatment, according to the researchers.
The study also highlights the role of online information in shaping patient decisions. Nearly all IVF patients surveyed in Australia reported relying heavily on fertility clinic websites, while more than 60% said they used social media platforms such as Facebook and Reddit to guide treatment choices.
To counter what researchers describe as a lack of reliable information, the team launched the Evidence-Based IVF website to provide independent, evidence-based information on IVF add-ons.
Lensen said the website improved patients’ understanding of treatment options and increased satisfaction with the information available to them.
“Although developed in Australia, the evidence is applicable to IVF patients globally,” she said. “We hope to see this resource endorsed and used by fertility specialists, clinics and patients around the world.”
