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The Complex World of Fertility Treatment Add-Ons: Are They Right for You?

The Complex World of Fertility Treatment Add-Ons: Are They Right for You?

Numerous fertility treatment add-ons exist and are in use by various clinics. How do you know which ones are right for you?

The use of the in-vitro fertilization (IVF) technology since 1981 has resulted in more than 200,000 babies in the USA (SART). If you happen to have a blocked or absent fallopian tube or your partner has a low sperm count, IVF is an effective procedure. But on average, IVF is successful only 30% of the time and most couples need at least three IVF cycles to achieve a successful conception.

Overtime, various fertility treatment add-ons have been developed that are designed to improve the outcome of IVF treatment. However, recent research has questioned the effectiveness of many of these add-on services, treatments, and procedures.

Lack of Evidence to Back Up Effectiveness of Most Add-Ons

A new study published in the peer-reviewed British Medical Journal in November 28th, 2016 and conducted by the Centre for Evidence-based Medicine at The University of Oxford suggests that most fertility treatment add-ons routinely offered to couples seeking in-vitro fertilization treatments may not work (British Medical Journal). The study concludes that the existing evidence does not support routine use of some of the IVF add-ons for the purpose of improving IVF success. Of at least 26 of the 27 “add-ons” typically promoted to infertile couples that are considering or undergoing IVF are not backed up by scientific evidence. Some of there IVF treatment add-ons include:

  • pre-implantation genetic screening
  • use of additional drugs that affect clotting and immune systems
  • blood tests to measure the immune system
  • endometrial scratching
  • mock embryo transfer
  • time-lapse embryo imaging
  • ovarian tissue freezing
  • segmented-IVF (separating collection and transfer cycles)

High Cost of Most Add-Ons Not Justified

These IVF add-on treatments can significantly add to the already high cost of an IVF cycle. The average IVF cycle costs $12,000 before medication, which typically cost an additional $3,000 to $5,000. The IVF add-on treatments can add up to $10,000 per IVF cycle.

New Information Creates Confusion for Prospective Parents

This new information and evidence creates confusion, misunderstanding, and lack of clear-path decision making for prospective parents who have an infertility diagnosis and are about to start or are already experiencing an emotionally difficult, and potential expensive and lengthy fertility treatment journey.

It is often unclear to patients which IVF add-ons are recommended for which infertility condition. Likewise, it is often not known to patients if for a particular add-on there is existing evidence recommending its use to improve IVF treatment outcome. For example, the endometrial scratch add-on, aimed to help the embryo implant successfully into the womb lining, is moderately beneficial only in women with more than two previous embryo transfers. Thus, its use in early IVF cycles is not recommended.

Treatment Add-Ons Use by Fertility Clinics Varies

Patients are often unaware that fertility clinics come with different flavors regarding their use of fertility treatment add-ons. Some clinics apply some of the IVF add-ons to all their patients while other clinics only recommend and use a particular add-on for a patient depending on the patient’s medical condition and family history. Patients should be aware of this discrepancy as they chose their respective fertility clinics.

Individuals undergoing or already receiving IVF may want to get the right information at the right time from the right source that will empower them to make informed treatment choices. This can optimize their treatment outcome, overall length, and total cost.

Questions to Ask About IVF Add-Ons

Here are some suggested questions to ask when being offered IVF add-ons:

a) Which IVF add-ons are most appropriate for our current medical condition? Why?

b) Is there scientific evidence that back-ups the add-on use in our particular case?

c) Is the recommended add-on safe and will it improve my IVF treatment outcome?

d) How many patients in your clinic opt to use this particular treatment add-on?

e) What is the exact cost of the treatment add-on? Is it a one-time cost or a per treatment cycle add-on cost?

Want to learn more about existing evidence for a particular IVF add-on and how that relates to your medical condition and family history? Schedule a free 15-minute consultation here to find out from our evidence-based fertility expert.

Keywords: IVF, infertility, add-ons, treatment, couples, evidence-based, research

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