Hope, Hype, and Hyaluronic Acid: What the Evidence Really Says About IVF Add-Ons

Walk into almost any UK fertility clinic, or browse its website, and you may be offered a menu of "add-ons": EmbryoGlue, endometrial scratching, intralipid infusions, platelet-rich plasma, immune-modulating steroids, acupuncture, and more. Data from the Human Fertilisation and Embryology Authority (HFEA) shows the vast majority of UK patients use at least one during treatment, often paying hundreds or thousands of pounds out of pocket for the hope of a better chance at a baby.

Two major studies published this year, led by researchers in Australia, ask an uncomfortable question that matters just as much here as it does there: does the evidence actually support any of this? And when patients are told the truth, does it change what they choose?

The evidence is thinner than the marketing suggests

The research team pulled together the most rigorous trial evidence available for ten of the most widely used add-ons, deliberately excluding studies with serious quality or integrity concerns. The findings were sobering:

• Only a handful of add-ons showed any real signal of benefit — EmbryoGlue and endometrial scratching for improving pregnancy and live birth rates, and a sperm-selection technique called PICSI for reducing miscarriage. Even these results were modest and, in some cases, didn't hold up under stricter analysis.

• Several commonly used add-ons showed no effect whatsoever, including corticosteroids and endometrial receptivity testing.

• The rest — including acupuncture, intralipid infusion, and platelet-rich plasma treatments — remain genuinely unproven, simply because the trials are too small or too few to give a reliable answer.

  
  

In plain terms: most IVF add-ons are being offered ahead of the evidence, not because of it — a pattern the HFEA has itself flagged for years through its traffic-light rating system.

Honesty changes minds

The second study tested something practical: does giving patients clear, evidence-based information actually help? Over 1,200 patients undergoing IVF were shown either a new plain-language resource or the kind of information typically found through a Google search. Those given the honest version understood the real risks, costs, and evidence quality far better — and were notably less inclined to pursue add-ons that don't have proven benefit. They also reported feeling more satisfied with the information overall, even when it was less optimistic.

Why this matters here

IVF sits at the collision of hope and commerce, and few areas of medicine expose patients to that tension so directly — a point echoed in the accompanying commentary to this research. Add-ons aren't necessarily worthless, and the evidence will keep evolving. But patient information should be part of the clinical care itself, not a marketing accessory.

The practical takeaway for anyone considering IVF add-ons, in the UK or anywhere else: ask for the evidence, not just the pitch. The freely available resource developed from this research is a regularly updated and worth a look before your next conversation with your clinic.

To access the resource click here