IVF Add-Ons Cost Thousands. A Clinical Trial Review Found Most Don’t Work.
Fertility clinics routinely offer optional procedures, tests, and treatments alongside a standard IVF cycle. They are called “add-ons,” and they are sold on the premise that they might improve a patient’s chances of having a baby. They can add thousands of dollars to a cycle that may already cost $15,000 or more without insurance.
A new systematic review of clinical trial data found that most of them do not have the evidence to justify that promise. Researchers evaluated commonly offered IVF add-ons and found only weak supporting evidence for three: EmbryoGlue, endometrial scratching, and physiological ICSI. The rest either showed no benefit or lacked sufficient high-quality data to draw any conclusion at all.
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The review did not conclude that these add-ons harm patients. It concluded that most lack robust evidence of benefit, and that patients are routinely paying for treatments that have not been validated in rigorous, live-birth-outcome trials. That distinction matters when IVF is already financially and emotionally depleting, and when the psychological pressure of a failed cycle can make any offered intervention feel worth trying.
Fertility add-ons are not regulated as drugs are. They do not need to demonstrate efficacy before being offered or charged for. Clinics set their own protocols. Some offer add-ons as standard components of their packages; others present them as personalized recommendations. Patients rarely have access to the underlying evidence before making the decision.
The researchers behind this review argue that clinics should be required to provide patients with clear, independent information about the evidence base for any recommended add-on before patients pay for it. The burden of asking the right questions should not fall entirely on people who are already navigating one of the more difficult medical experiences there is.
If you are considering IVF, the most useful question to ask about any add-on is whether it has been tested in a randomized controlled trial with live birth as the primary endpoint. If the answer is no, or if the clinic cannot point to specific trial data, that is the information you need to weigh.
Source: Systematic review of IVF add-on clinical trial evidence, University of Melbourne. Published 2025. Via Maternie June 26 edition.