Add-ons for assisted reproductive technology: can we be honest here?

At present there are many add-ons for patients under- going in vitro fertilization but little reliable evidence of benefit. We should inform patients about the limited evidence when recommending an add-on.

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Volume 112, Issue 6, Pages 971–972


Cynthia Farquhar, M.B.Ch.B., M.D., M.P.H.


Adjuncts, more often known as add-ons, are now part of the landscape of an in vitro fertilization cycle. Since the early days of in vitro fertilization, fertility services have rightly been seeking improved success rates. At present there are a multitude of choices for patients who are usually presented with a menu of add-ons to choose from. This is driven by the desire to give patients the best chances of becoming parents. This Views and Reviews series discusses all aspects of add-ons. It is not exhaustive as even as we are finishing the preparation of the series, there is a new study about the use of cytokines as an add-on. The overall conclusion from this series of articles is that despite considerable efforts to establish benefits with add-ons that there is a paucity of data when we consider the outcome of live birth.

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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 Luis Hoyos
about 2 years ago

In regards to the views and reviews series of articles published in the December issue. I have to say that I am very disappointed at the evidence on the use of clinical and laboratory add-ons in IVF. In my opinion, this is a very hot topic not only academically but also in every-day practice. I am sure all of us have been approached by patients asking about what specific "vitamins" could help them get pregnant or improve their IVF outcomes. At the same time all of us have been approached by companies advertising "fertility supplements" using very low quality studies to support their claims. Unfortunately, and I have to plead guilty in this case, despite knowing the status of the evidence most of us frequently succumb to the use of add-ons in an attempt to do "something" extra and using the "there is no harm to their use" argument. Unfortunately, we often fail to take into account the "financial harm" the patients may ensue and how these resources may be better allocated toward another cycle in the future.  I applaud ongoing efforts to try and tease out which of these add-ons will truly benefit our patients but as of right now I recognize that the current landscape is disappointing.