Clinical adjuncts in in vitro fertilization: a growing list
No high-quality evidence supports the routine use of most clinical add-ons during in vitro fertilization treatment; evidence-dictated mechanisms are needed be- fore introducing newer interventions into routine clinical practice.
Volume 112, Issue 6, Pages 978–986
Mohan S. Kamath, M.S., Mariano Mascarenhas, M.S., Sebastian Franik, M.D., Emily Liu, F.R.A.N.Z.C.O.G., Sesh Kamal Sunkara, M.D.
A growing list of clinical adjuncts are being used during in vitro fertilization (IVF) treatment. Most of these IVF add-ons (such as growth hormone, aspirin, heparin, dehydroepiandrostenedione, testosterone, male and female antioxidants, and screening hysteroscopy) are being introduced into routine clinical practice in a hurried manner without any clear evidence of benefit in most cases. These add-ons make the IVF more complicated and increase the overall cost for the treatment, which is borne by the couples and health care providers. Our current review found no high-quality evidence to support the use of these IVF add-ons in routine practice. Large, well-designed, randomized trials must be conducted to evaluate the effectiveness and safety of these interventions. There is also a pressing need to develop an evidence-dictated mechanism for introducing newer interventions into routine clinical settings.