When Dr. Sarah Lensen and her team at the University of Melbourne began sorting through 157 clinical trials on IVF add-on treatments, they expected to find some hidden gems—procedures that science hadn't yet fully appreciated. Instead, they found something equally valuable: a clear signal that patients deserve better than marketing hype when they're already navigating one of life's most emotionally fraught journeys.
Their systematic review, published in The Lancet Obstetrics, Gynaecology, & Women's Health, analyzed 85 rigorously vetted trials and found that seven widely offered IVF add-ons—including acupuncture, corticosteroids, endometrial receptivity testing, and pre-implantation genetic testing for aneuploidy—showed either no measurable effect on fertility or results too weak to draw firm conclusions. The researchers excluded 72 trials from consideration due to trustworthiness concerns, highlighting just how muddied the evidence landscape has become.
More than 70% of IVF patients in Australia, New Zealand, and the United Kingdom report using at least one add-on during treatment. Yet with success rates hovering around 30–40% per cycle and declining sharply with age, patients are often paying premium prices for procedures that science hasn't validated.
"Unproven add-ons can lead to false hope, greater financial strain and unnecessary medical procedures at what can already be a very difficult time for patients," said Dr. Lensen. She urged clinics to reconsider offering treatments that lack robust evidence: "Their availability is often perceived by patients as an implicit endorsement of benefit."
The review did identify three add-ons with weak but promising evidence: EmbryoGlue, an embryo transfer medium containing hyaluronic acid that may modestly improve pregnancy and live birth rates; endometrial scratching, a minor procedure that showed similar potential; and physiological intracytoplasmic sperm injection (PICSI), which may lower miscarriage risk. Even these, Dr. Lensen stressed, require larger, more rigorous trials before any firm conclusions can be drawn.
The value of this research isn't just in debunking—it's in empowerment. By systematically narrowing the field to trustworthy evidence, the Melbourne team has given patients and clinicians a clearer map through an increasingly commercialized landscape. Infertility care is, in many countries, largely privately provided, which can blur the line between innovation and upselling. This review restores scientific rigor to that conversation, offering people facing impossible decisions something money can't always buy: honest information.