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.

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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.

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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. 


Go to the profile of Alexander Quaas
almost 2 years ago

Excellent review on the growing list of adjuncts used in IVF treatments, demonstrating that a lot more research is needed in this area. Multi-center translational trials should focus on the compounds that have shown promise in prior underpowered or poorly designed studies, such as growth hormone, and androgens.

Are the authors of this review aware of ongoing trials on any of the listed compounds that are either in the planning phase or expected to be completed soon? In the authors' opinion, which ones hold the most promise, and deserve the most attention?