In vitro fertilization add-ons for the endometrium: it doesn’t add-up

There is no robust evidence to support the use of in vitro fertilization add-ons targeting the endometrium, many of which are costly and carry a risk of harm.

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Volume 112, Issue 6, Pages 987–993

Authors:

Sarah Lensen, Ph.D., Norman Shreeve, B.M.B.S., Kurt T. Barnhart, M.D., M.S.C.E., Ahmed Gibreel, M.D., Ernest Hung Yu Ng, M.D., Ashley Moffett, M.D.

Abstract:

The probability of live birth from an in vitro fertilization (IVF) cycle is modest. Many additional treatments (add-ons) are available which promise to improve the success of IVF. This review summarizes the current evidence for common IVF add-ons which are suggested to improve endometrial receptivity. Systematic reviews of randomized controlled trials and individual trials were included. Five add-ons were included: immune therapies, endometrial scratching, endometrial receptivity array, uterine artery vasodilation, and human chorionic gonadotropin instillation. The results suggest there is no robust evidence that these add-ons are effective or safe. Many IVF add-ons are costly, consuming precious resources which may be better spent on evidence-based treatments or further IVF. Large randomized controlled trials and appropriate safety assessment should be mandatory before the introduction of IVF add-ons into routine practice.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.