Add-ons in the laboratory: hopeful, but not always helpful

We discuss the lack of high-quality evidence to support the routine use of laboratory add-ons during in vitro fertilization treatment.

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Volume 112, Issue 6, Pages 994–999


Sarah Armstrong, M.B.Ch.B., Monique Atkinson, B.Sc., M.B.B.S., Jeanette MacKenzie, B.Sc., M.C.E., Allan Pacey, Ph.D., Cynthia Farquhar, M.B.Ch.B., M.D., M.P.H.


All the steps in an in vitro fertilization cycle are important but none more so than those that occur in the laboratory. To improve the chance of success, adjuncts, commonly referred to as ‘add-ons’, are offered. Yet as with other new interventions, add-ons in the laboratory require justification by well-designed studies prior to being offered as routine practice. Add-ons aim to improve the chance of a take-home baby, but, their safety and efficacy is less than clear. In addition, the financial burden from the use of add-ons is often borne by the couple. This review of the most commonly used laboratory add-ons did not find any high-quality evidence to support their use in 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.