June 25, 2026
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A large-scale analysis of add-on procedures that are being marketed to people going through in vitro fertilization found a lack of robust evidence that many increased the probability of live births.
Each year, millions of people with fertility issues undergo in vitro fertilization, a process that involves medication to stimulate ovulation and minor surgery to retrieve eggs and then implant embryos fertilized outside the body into a woman's womb. Add-on procedures have been increasingly marketed as ways to improve the chances of success – which vary widely based on age and other factors.
But new analysis of available research about add-on procedures found that the majority of these may offer little – if any – benefit, despite their hefty price tags. The study was published Tuesday in the Lancet's Obstetrics, Gynaecology, & Women’s Health.
Due to growing concern about the research backing these emerging technologies, the goal of the new analysis was to offer a comprehensive evaluation of 10 of the most common procedures – only three of which had valid evidence to back them, according to the authors.
Dr. Diana Laird, a professor of obstetrics and gynecology at the University of California, San Francisco, who was not involved in the study, told the New York Times that the results were "hugely disappointing for patients."
People going through IVF – often paying out-of-pocket because many health insurance plans do not cover it – have been “having to make decisions which have, until now, been not well-informed,” Laird said.
The researchers found that an add-on called endometrial scratching, which involves scratching the lining of the uterus to encourage the embryo to attach, "might increase the probability of live birth."
Physiological intracytoplasmic sperm injection, or PICSI, a procedure used to try to identify viable sperm, had limited evidence that it may help lower the risk of miscarriage.
The researchers also found a "possible benefit" from EmbryoGlue, which uses a medium rich in hyaluronic acid during embryo transfer.
But the seven other add-ons were found to have no benefit or weak or inconclusive research supporting them. These included acupuncture, corticosteroid medications, endometrial receptivity testing, intralipid infusion, preimplantation genetic testing, intrauterine infusion of platelet-rich plasma and intraovarian injection of platelet-rich plasma.
The researchers developed a website to offer detailed findings about the add-ons they reviewed.
