What are IVF add-ons and do you need them?
01.09.2026
Medically reviewed by Amy Barrie, Chief Scientific Officer at CRGH.
From EmbryoGlue® and time-lapse imaging to genetic testing and immune therapies, there are a growing number of IVF add-ons available. But deciding which one is for you – or even whether you need one – can feel overwhelming.
Some IVF add-ons are backed by promising evidence, others are still being researched. However, some have been shown not to improve the chance of having a baby at all. So, how do you know what’s worth considering? At CRGH, we believe patients should have clear, evidence-based information to help them make informed decisions about their treatment.
Rather than recommending add-ons routinely, we assess each patient’s individual circumstances and discuss the options that may be appropriate based on the latest scientific evidence.
In this guide, we’ll explain what IVF add-ons are, why they might be recommended for some patients but not others, what the HFEA traffic light system means, and what the current science tells us about the treatments.
What are IVF add-ons?
IVF add-ons are optional tests, treatments or laboratory techniques that might be offered alongside standard IVF treatment.
Some are designed to improve embryo selection, while others focus on sperm quality, implantation, embryo development or genetic testing.
But it’s not always clear which ones are beneficial. And some have limited evidence or are considered ‘experimental’. This is why organisations such as the Human Fertilisation and Embryology Authority (HFEA) regularly review the available research and publish guidance to help patients understand the current evidence.
Do IVF add-ons improve your chances of success?
Some add-ons have shown promise in specific groups of patients, while others haven’t been shown to improve the chance of having a baby. In many cases, research is still ongoing.
That’s why it’s important to look beyond headlines or online recommendations. A treatment that might be suitable for one patient might offer little or no benefit to another.
There isn’t a single add-on that’s right for everyone. Decisions are made based on your age, fertility diagnosis, previous treatment history and individual circumstances.
What do the HFEA ratings mean?
The HFEA uses a traffic-light rating system to help patients understand the evidence behind different fertility treatment add-ons. The ratings look at whether there’s good-quality evidence that an add-on improves a particular treatment outcome.
- Green means there is good-quality evidence that the add-on improves the outcome being assessed.
- Yellow means the evidence is conflicting, so it’s unclear whether it helps.
- Grey means there isn’t enough good-quality evidence to reach a conclusion.
- Black means the evidence shows the add-on does not improve the outcome being assessed.
- Red means there might be safety concerns and/or evidence that the add-on may reduce treatment effectiveness.
An add-on can have different ratings depending on the outcome being considered or the patients it’s being used for.
The HFEA also reviews its ratings as new research becomes available, so they can change over time.
You can view the HFEA’s latest treatment add-on ratings on the HFEA website.
IVF add-ons: What you need to know
| IVF add-on | What is it? | Who might it be suitable for? | What does the evidence say? |
|---|---|---|---|
| EmbryoGlue® | A hyaluronan-enriched embryo transfer medium used during embryo transfer. Despite its name, it isn’t a glue. | May be considered for patients who have experienced recurrent implantation failure. | Some studies suggest it may improve implantation, although the evidence remains inconclusive and may benefit some patients more than others. |
| Time-lapse imaging | Specialised incubators continuously monitor embryo development without disturbing the embryos. | Can be used for all patients. | Provides embryologists with additional information when assessing embryos, although evidence that it improves live birth rates remains limited. |
| Advanced sperm selection (ZyMot®) | A laboratory technique that selects sperm with good movement characteristics before IVF or ICSI. | Patients with male-factor infertility, raised sperm DNA fragmentation or previous poor embryo development. | May reduce sperm DNA fragmentation, but evidence that it improves live birth rates is currently limited. |
| PGT-A* | A genetic test performed on embryos to assess whether they have the expected number of chromosomes before transfer. | May be considered for selected patients, including those with recurrent miscarriage, recurrent implantation failure, increased maternal age or multiple embryos available. | PGT-A may reduce the risk of miscarriage for some patients, but current evidence doesn’t show that it increases the overall chance of having a baby for everyone undergoing IVF. It can also provide additional information to help guide embryo selection. |
| ERA | A test designed to identify the best timing for embryo transfer by analysing the uterine lining. | Previously offered for recurrent implantation failure. | Current evidence does not support its routine use in IVF treatment. |
| PRP (Platelet-Rich Plasma) | Uses concentrated platelets from your own blood to try to improve ovarian function or the uterine lining. | Sometimes discussed for diminished ovarian reserve or a thin endometrium. | Currently considered experimental and is not routinely recommended because there is insufficient evidence that it improves the chance of having a baby. |
| PICSI® | An advanced sperm selection technique used alongside ICSI. | May be discussed in selected cases of male-factor infertility. | Current evidence has not shown that PICSI improves live birth rates compared with standard ICSI. |
| IMSI | An advanced sperm selection technique in which sperm are examined at very high magnification before ICSI. | May be discussed in selected cases of male-factor infertility. | Current evidence has not established that IMSI improves live birth rates compared with standard ICSI. |
| Immune treatments – intralipids | A treatment designed to alter the immune environment during implantation. | Sometimes discussed for recurrent miscarriage or repeated implantation failure. | Current evidence does not support its routine use in fertility treatment. |
| Immune treatments – IVIG | An immune treatment designed to alter the immune environment during implantation. | Sometimes discussed for recurrent miscarriage or repeated implantation failure. | Current evidence does not support its routine use in fertility treatment. |
| Immune treatments – steroids | Steroids may be used in an attempt to alter the immune response during implantation. | Sometimes discussed for recurrent miscarriage or repeated implantation failure. | Current evidence does not support their routine use as a fertility treatment add-on. |
| Assisted hatching | A procedure designed to help an embryo hatch from its outer layer before implantation. | Previously offered to selected patients. | Current evidence does not support routine use as it has not been shown to improve the chance of having a baby. |
| Endometrial scratching | A procedure in which the lining of the womb is deliberately scratched before treatment, with the aim of encouraging implantation. | Previously offered to selected patients. | Current evidence does not support routine use as it has not been shown consistently to improve the chance of having a baby. |
Why doesn’t CRGH recommend every add-on?
It’s understandable to think that adding more treatments might improve your chances of success. However, more treatment doesn’t always mean better outcomes.
Some add-ons have been shown to benefit specific groups of patients, while others have little or no evidence that they improve the chance of having a baby. New research is also being published all the time, meaning recommendations can change as more evidence becomes available.
At CRGH, we continually review the latest scientific research and only recommend additional treatments where there’s a clear clinical rationale and the potential to benefit the individual patient. This helps us ensure your treatment plan is based on the best available evidence, rather than trends or unnecessary interventions.
How do I know if an IVF add-on is right for me?
During your consultation, your fertility specialist will explain whether any additional treatments might be appropriate for your circumstances, discussing both the potential benefits and the current evidence so you can make an informed decision.
Decisions will also be made depending on factors like:
- Your age
- Your fertility diagnosis
- Your previous IVF history
- Embryo quality
- Sperm quality
- Whether you’ve experienced recurrent miscarriage or recurrent implantation failure
Making the right choice for your treatment
With so many IVF add-ons available, understanding the evidence and the guidance isn’t always straightforward.
At CRGH, every treatment recommendation is personalised and guided by the latest scientific evidence.
Your fertility specialist will talk you through your options, explain the potential benefits and limitations, and help you make informed decisions about your treatment.
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