IVF Add-ons

Optional tests and procedures sold on top of a standard IVF cycle with the promise of raising the chance of a live birth. Context: roughly 60% of IVF attempts fail, which creates demand for anything that might tilt the odds.

The 2026 review

Lancet Obstetrics, Gynaecology & Women's Health, published 23 June 2026. 157 randomised trials were screened with a 2023 research-integrity checklist (implausible timelines, odd participant data, paper-trail gaps); nearly half failed. The surviving 85 trials covered ten add-ons:

Verdict	Add-ons
Weak evidence of benefit	endometrial scratching; EmbryoGlue (hyaluronic-acid transfer medium); PICSI (physiological sperm selection)
No effect, limited data	corticosteroids; PGT-A chromosome screening; endometrial-receptivity biopsy
Too little data to judge	acupuncture; intralipid infusion; platelet-rich plasma (uterine); platelet-rich plasma (ovarian)

Median trial size was ~160 patients, underpowered for small effects; subgroup benefit could not be excluded.

Why it matters beyond fertility

• Research integrity is the first filter, not the last. Half the literature on a lucrative elective procedure did not pass a fraud screen; any evidence summary that skips that step overstates what is known.
• PGT-A's null result matters for Polygenic Embryo Screening, since PGT-A is the established screen that startups extend into polygenic scoring; the chromosome layer itself has not shown a live-birth benefit.

Open questions

• Whether the three "weak benefit" procedures survive larger, cleaner trials.
• Which subgroups, if any, benefit from the no-effect and unknown categories.
• Whether journals adopt the integrity checklist pre-publication, as the authors urge.

Related

• Do High-Tech IVF Add-ons Work (Economist) — source.
• Polygenic Embryo Screening — the newest add-on category.