Which fertility add-on treatments are effective and worth the investment?

The Human Fertilization & Embryology Authority (HFEA) in the UK has released a report testing various popular “add-on” fertility treatments from embryo glue to pre-implantation screening and endometrial scratching. These add-ons are fertility treatments that are typically offered at an additional cost. Six of the techniques the HFEA examined are still relatively new or have conflicting evidence. Another six techniques have been around for a while without evidence of their effectiveness. We’re hoping this evaluation of add-on treatments will be helpful for our Ovally customers, as well as anyone else undergoing fertility treatments.

HFEA’s approach to rating the treatments was conservative – treatments only received a ‘green’ rating if at least one high-quality randomized clinical trial showed that the procedure was effective and safe. None of the add-on treatments received a green rating.

Five techniques met the HFEA’s ‘amber’ rating criteria – they had either a small amount of evidence or conflicting evidence of their effectiveness, and further research is needed. Techniques that met these criteria included:

  • Artificial egg activation calcium ionophore (using calcium ionophores to stimulate “egg activation” during embryo development)
  • Elective freeze all cycles (freezing all embryos at the end of an IVF cycle prior to thawing and implanting one, instead of implanting one fresh embryos right away)
  • Embryo glue (using a substance called “hyaluronan” to improve the chance of the embryo implanting in the womb)
  • Endometrial scratching (scratching the lining of the womb to trigger the body’s repair response and receptive hormones)
  • Pre-implantation genetic screening (which we talked about in the last post; it received an amber rating as the body of evidence shows that sometimes test results are wrong and embryos can be damaged when cells are removed)
  • Time-lapse imaging (used to review embryo development without removing embryos from the incubator)

Another 6 techniques received a red rating from the HFEA, indicating there’s no evidence that the procedure is effective and safe:

  • Assisted hatching (helping embryos ‘hatch’ by thinning the “zona pellucida” they have to emerge from)
  • Intrauterine culture (having early embryos develop in an intrauterine culture for a few hours in the womb)
  • Preimplantation screening (only if done in early embryo development prior to the blastocyst stage, when the risk of damaging the embryo is much higher)
  • Reproductive immunology (suppressing the mother’s immunity under the hypothesis that her immune system may treat an embryo as an invader)
  • Intracytoplasmic morphologic sperm injection (using a microscope to view sperm under high magnification)
  • Physiological intracytoplasmic sperm injection (having sperm bind with “hyaluronic acid” before selecting the ones that did)

We hope the HFEA’s report will be helpful in your discussions with your physician on which add-on treatments do or don’t make sense for your particular situation.




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