Most IVF Add-Ons Lack Strong Evidence of Benefit, Meta-Analysis Suggests
Australia: Companion studies found that many commonly used in-vitro fertilization (IVF) add-on treatments have little or no proven benefit despite their popularity. Patients often obtain information about these interventions from social media and IVF clinic websites, where benefits may be overstated and evidence inadequately presented. The studies showed that access to an evidence-based educational website improved patients' understanding of IVF add-ons, helping them make more informed treatment decisions.
The findings highlight the need for clearer patient information and well-designed clinical trials to better assess the benefits and potential harms of these additional therapies.
The findings were reported in The Lancet Obstetrics, Gynaecology, & Women’s Health by Sarah Lensen and colleagues from the Royal Women's Hospital and the University of Melbourne, Australia. The researchers conducted a comprehensive review of evidence surrounding ten commonly used IVF add-ons, which are additional procedures, medications, or techniques offered alongside standard IVF treatment to improve pregnancy and live birth outcomes.
With the growing use of IVF add-ons despite uncertain effectiveness, researchers conducted a comprehensive review of randomized trials evaluating ten commonly used interventions, including PGT-A, endometrial receptivity testing, corticosteroids, EmbryoGlue, endometrial scratching, platelet-rich plasma therapies, acupuncture, and intralipid infusion.
Applying strict quality and trustworthiness criteria, the team screened more than 12,000 records, ultimately including 85 randomized trials and excluding 72 studies due to concerns about research integrity or methodological quality.
Live birth was the primary outcome assessed. The analysis found that most IVF add-ons either showed no meaningful benefit or lacked sufficient high-quality evidence to support routine use.
Key findings from the review include:
- Endometrial scratching was associated with a small increase in the likelihood of live birth.
- EmbryoGlue showed no clear improvement in live birth rates.
- Preimplantation genetic testing for aneuploidy (PGT-A) did not demonstrate a significant live birth benefit.
- Endometrial receptivity testing showed no proven advantage.
- Corticosteroid use was not associated with improved live birth outcomes.
- Evidence for physiological intracytoplasmic sperm injection, acupuncture, intralipid therapy, and platelet-rich plasma treatments remained inconclusive because of limited or low-quality data.
- Nearly half of the potentially eligible studies were excluded because of concerns about study reliability.
The researchers noted that many IVF add-ons are widely promoted despite limited evidence supporting their effectiveness. They also identified 28 additional trials since the previous reviews, highlighting the rapid growth of research in this field.
The authors stressed the importance of providing patients with clear, evidence-based information on the benefits, risks, costs, and uncertainties of IVF add-ons. They concluded that most add-ons lack proven benefit and called for large, high-quality randomized trials to better assess their effectiveness and safety.
Reference:
Lensen, S., Wilkinson, J., Steeper, M., Melo, P., Kamath, M. S., Craciunas, L., Wang, R., Jordan, V., Showell, M., Attinger, S., Afroz, A., Wely, M. V., & Farquhar, C. (2026). Safety and effectiveness of ten common in-vitro fertilisation add-ons: A systematic review and meta-analysis. The Lancet Obstetrics, Gynaecology, & Women's Health. https://doi.org/10.1016/S3050-5038(26)00054-3
Next Story