New Research Challenges IVF Add-Ons: What Every IVF Patient Needs to Know

If you've been through IVF, you've probably been offered (or at least heard about) an "IVF add-on."

Perhaps it was an extra test, genetic testing for aneuploidy, acupuncture, steroids, immune treatment, platelet-rich plasma (PRP), or another treatment that promised to improve your chances of success.

When you're investing so much emotionally, physically and financially into IVF, it's completely understandable to wonder:

"If this might improve my chances, shouldn't I do it?"

This week, two important papers published in The Lancet Obstetrics, Gynaecology & Women's Health have provided some of the strongest evidence to date about IVF add-ons and the findings could change conversations between patients and fertility specialists around the world.

Let's break down what this means for you.

What are IVF add-ons?

IVF add-ons are additional treatments, medications, procedures or laboratory techniques that are offered alongside standard IVF treatment.

They're designed to improve one or more of the following:

• implantation

• pregnancy rates

• live birth rates

• miscarriage rates

The challenge?

Many have entered clinical practice before strong evidence has demonstrated they actually improve the chance of taking home a baby. And many IVF websites may over promise on what these add-ons are capable of and do not discuss them in enough detail.

What did the new research find?

Researchers from the University of Melbourne performed one of the largest systematic reviews and meta-analyses ever conducted on IVF add-ons.

Rather than simply combining every available study, they first assessed the trustworthiness of the evidence and excluded studies they considered unreliable before analysing the remaining high-quality trials. Ultimately, they analysed 85 trusted randomised trials examining 10 commonly used IVF add-ons.

Which add-ons showed possible benefit?

The review found weak evidence (not strong or definitive evidence) for potential benefit with only three interventions:

• EmbryoGlue® may improve pregnancy and live birth rates.

• Endometrial scratching may improve pregnancy and live birth rates in some patients.

• Physiological ICSI (PICSI) may reduce miscarriage risk through improved sperm selection.

  
  

Importantly, the researchers describe these findings as weak evidence, meaning more high-quality research is still needed before these treatments should be routinely offered or recommended.

Which add-ons did not have convincing evidence?

For the remaining add-ons, researchers found either no demonstrated benefit or insufficient high-quality evidence.

These included:

• acupuncture

• corticosteroids (steroids)

• preimplantation genetic testing for aneuploidy (PGT-A) for improving overall IVF success in unselected patients

• endometrial receptivity testing

• platelet-rich plasma (PRP) treatments

• intralipid therapy

  
  

This doesn't necessarily mean these treatments never help.

It means that current evidence isn't strong enough to confidently say they improve outcomes for most IVF patients. 

Why is this research so important?

For years, patients have faced an incredibly difficult situation. Trying to figure out what may be the best tests, treatments, procedures to help them on their path to parenthood and are willing to look into every option.

This makes IVF patients vulnerable, searching for possible answers.

However, many IVF add-ons are marketed on IVF websites with hopeful language that may not be the complete picture! Many fertility and IVF clinics genuinely want to maximise their patients' chances of success. I'm not doubting that at all, but in order to make clear decisions, open and honest conversations need to had.

Patients often feel:

"If I don't do everything possible, will I regret it?"

The other clear issue is that they can come at a significant financial cost. Add-ons can vary in cost, ranging from a few hundred dollars, while others add thousands of dollars to an IVF cycle. The authors highlight that more than 70% of IVF patients in Australia, New Zealand and the UK report using at least one IVF add-on during treatment.

When evidence is uncertain, patients deserve to know that before spending thousands of dollars.

Plus - A new evidence-based IVF website has also been launched

Alongside the review, researchers published another important study evaluating a new independent patient information website designed to explain IVF add-ons using the best available evidence.

The website was developed because researchers recognised that many patients obtain information from:

• fertility clinic websites

• social media

• online forums

  
  

Unfortunately, these sources don't always present balanced information about benefits, risks and uncertainty.

The study found that patients who used the website:

✅ had a better understanding of the evidence

✅ were more satisfied with the information they received

✅ were less interested in add-ons that lacked strong evidence

Interestingly, participants also reported feeling less optimistic after reading the website, not because the information was harmful, but because it presented a more realistic picture of what the evidence currently shows.

As difficult as that may feel emotionally, realistic expectations are an important part of truly informed consent.

Have a look and see for yourself: https://www.unimelb.edu.au/ivf

So what does this mean for IVF patients?

This research doesn't mean you should automatically refuse every IVF add-on.

It means you should have informed conversations with your doctor and clinical team.

Before agreeing to any additional treatment, consider asking:

• Could this add on benefit me and my treatment?

• What evidence supports this treatment for someone like me?

• Does it improve live birth rates?

• Are there risks or side effects?

• What will it cost?

• Is this recommended for my specific diagnosis or being offered routinely?

• If the evidence is uncertain, why do you think it's appropriate in my situation?

  
  

Remember, fertility treatment should be personalised, not simply protocol-driven. It's about understanding your medical history, your TTC journey, your previous IVF cycles to help ensure your care is tailored and suited to you!

This research recognised that patient education is part of good healthcare, that being thoroughly informed means you can make informed decisions about your care, it's not simply an afterthought.

And at the end of the day, medicine is always evolving, and today's evidence may change as larger, better-designed studies are completed. So we could be having different conversations about these add-ons in the years to come.

Where does a fertility nurse fit into all of this?

One of the hardest parts of IVF isn't simply taking medications or attending appointments.

It's trying to make complex decisions while carrying enormous emotional pressure.

As an independent, private fertility nurse, my role isn't to tell you what treatment to choose.

It's to help you:

• understand the evidence

• interpret medical jargon and research in plain English

• weigh the benefits, risks and costs

• prepare questions for your fertility specialist

• make informed decisions that align with your values and circumstances

• reduce emotional stress and pressure

• talk through any concerns or worries

So if that sounds like something that could be useful to you, don't hesitate to reach out! (or book a free nurse chat via the link below)

The bottom line

This week's publications represent an important milestone in fertility care.

Rather than taking hope away, they encourage something even more valuable: informed decisions and hope. Hope built on transparent, high-quality evidence allows patients to make decisions with confidence, rather than feeling pressured to try every available option simply because it's offered. But it also doesn't mean that you shouldn't do any of them because the evidence is lacking.

I hope this helps you to better understand this new research and to have open conversations with your doctor and clinical team about your care.

Because informed patients are empowered patients.

At My Fertility Nurse, I believe every person deserves access to independent, evidence-based fertility information, free from fluff or fear tactics so you can feel confident and in control of your fertility journey.

If you'd like help understanding your IVF treatment plan, deciding whether an add-on is right for you, or preparing questions for your next appointment, let me be your fertility bestie, educate you, guide you and helping you decode all the medical jargon that can up along the way. Book a free call with me today.

REFERENCES:

1. Lensen S, Wilkinson J, Steeper M et al.

   Safety and effectiveness of ten common in-vitro fertilisation add-ons: a systematic review and meta-analysis, The Lancet Obstetrics, Gynaecology, & Women’s Health, 2026; 0, DOI: 10.1016/S3050-5038(26)00054-3

2. Afroz A, Smith H, Copp T et al.

   Evaluation of a codesigned resource about in-vitro fertilisation add-ons: an online, parallel-group, single-blinded, randomised trialThe Lancet Obstetrics, Gynaecology, & Women’s Health, 2026; 0, DOI: 10.1016/S3050-5038(26)00114-7