IVF Add-Ons: Which Are Worth It?

When you're already investing so much — emotionally, physically, and financially — into IVF, it can feel tempting to say yes to anything that might increase your odds. Enter the world of IVF add-ons: a menu of optional extras that clinics may offer, often for a hefty price. These include things like embryo glue, endometrial scratch, assisted hatching, time-lapse imaging, and PGT-A genetic testing.

But which of these add-ons are truly helpful? Which are backed by science — and which might just be marketing?

In this post, we’ll break it down clearly and compassionately, so you can make informed choices on your IVF journey.

What Are IVF Add-Ons?

IVF add-ons are optional treatments or procedures offered in addition to standard IVF. They’re usually not included in base IVF packages and often come at an extra cost. Clinics sometimes suggest them to increase the chances of implantation or pregnancy, particularly if previous IVF attempts have failed or if you're over a certain age.

But here's the catch: most add-ons aren’t supported by high-quality evidence, and their use is debated even among fertility specialists.

The Most Common IVF Add-Ons Explained

Below is a breakdown of some of the most widely offered IVF add-ons in the UK:

Preimplantation Genetic Testing for Aneuploidy (PGT-A)

Cost: ~£2,000–£3,500
What it is: A biopsy of embryos to screen for chromosomal abnormalities before transfer.

Pros:

• May reduce miscarriage risk in older patients

• Helps avoid transferring non-viable embryos

Cons:

• Doesn’t guarantee success

• Can sometimes discard embryos that might have implanted

• Evidence is mixed, especially for younger patients

Evidence level: ⚠️ Moderate — potential benefit in women over 37 or with repeated IVF failure

Embryo Glue

Cost: ~£300–£600
What it is: A sticky culture medium that contains hyaluronan to help embryos attach to the uterine lining.

Pros:

• May slightly improve implantation rates

Cons:

• Improvement is marginal; studies are small

• Not universally recommended

Evidence level: ❓ Low — may offer a small benefit but not proven to increase live birth rates

Endometrial Scratch

Cost: ~£200–£400
What it is: A procedure that disrupts the uterine lining in the cycle before embryo transfer, theoretically to boost receptivity.

Pros:

• Thought to provoke a healing response that might aid implantation

Cons:

• Recent studies suggest no benefit for most people

• Can be painful and invasive

Evidence level: 🚫 Not recommended — not supported by recent high-quality trials

Time-Lapse Imaging (Embryoscope)

Cost: ~£500–£1,200
What it is: Continuous video monitoring of embryos in the incubator to select the most viable for transfer.

Pros:

• Non-invasive

• Allows better embryo selection

Cons:

• No clear proof it improves live birth rates

• Expensive for the value offered

Evidence level: ❓ Low to moderate — may be useful in labs with good protocols, but no strong evidence for outcome improvement

Assisted Hatching

Cost: ~£300–£500
What it is: A lab technique to thin or open the outer shell of the embryo to help it “hatch” and implant.

Pros:

• Might help in specific cases (e.g., frozen embryos, older patients)

Cons:

• Could harm the embryo

• No significant evidence of benefit in most groups

Evidence level: ⚠️ Limited — potentially helpful in select cases only

Red Flag: Add-Ons Without Evidence

There are also add-ons that are not supported by any reliable data, yet still offered by some clinics. These include:

• Immunological testing and treatments (e.g., intralipids, NK cell tests)

• Sperm DNA fragmentation tests (questionable clinical value in IVF)

• Embryo “washes” or immune-boosting cocktails

The Human Fertilisation and Embryology Authority (HFEA) has a traffic light system to help patients navigate these — most add-ons fall under red or amber, meaning there is little or no evidence to support them.

Should You Say Yes to Any Add-Ons?

The answer is personal, but here are five guiding principles to consider:

1. Start with the evidence. Use the HFEA website or ask your clinic for the latest data on efficacy.

2. Ask if it’s right for your case. Some add-ons might be helpful for recurrent IVF failure or advanced maternal age — but not necessary for everyone.

3. Be cautious if it’s “just in case.” Many clinics bundle extras without proven benefit.

4. Look at live birth rates, not just implantation. A better chance of implantation doesn’t always mean a baby at the end.

5. Consider your emotional and financial bandwidth. Sometimes the peace of doing everything possible helps — but sometimes it adds unnecessary pressure.

The Emotional Side of Add-Ons

It's easy to feel like declining an add-on means giving up on a chance. But the truth is, IVF success is about quality over quantity — not how many extras you add in. Saying no doesn’t mean doing less; it means choosing wisely and protecting your energy and finances for what truly works.

IVF add-ons can feel like magic ingredients — especially when you’re desperate for answers. But more is not always better. As frustrating as it is, the most effective path is often the simplest, and supported by strong, transparent science.

Stick to clinics that respect your right to question and research. The best care isn’t about selling you more — it’s about walking beside you with honesty, empathy, and expertise.