How common is add-on use and how do patients decide whether to use them? A national survey of IVF patients.

A recent Australian study examined how often women undergoing in vitro fertilization (IVF) use additional treatments, called "add-ons," to improve their chances of pregnancy. Researchers surveyed 1,590 women who had undergone IVF between 2017 and 2020 about their use of supplementary treatments beyond standard IVF procedures.

The findings revealed that 82% of women used at least one add-on treatment during their IVF journey. The most commonly used add-ons were acupuncture, genetic testing of embryos, and Chinese herbal medicine. Most of these treatments came with additional costs beyond standard IVF fees, with 72% of women paying extra for these services.

Interestingly, about half of the women learned about these add-ons from their fertility specialist, and most felt the decision to use them was made jointly with their doctor. Women reported placing high importance on scientific evidence for safety and effectiveness, and nearly half assumed the add-ons were known to be safe.

However, the reality is that most IVF add-ons lack robust scientific evidence supporting their safety and effectiveness. This suggests a significant gap between what patients believe about these treatments and what research actually shows. Two-thirds of women experienced some regret about using add-ons, particularly when IVF was unsuccessful.

For patients considering acupuncture or other complementary treatments alongside IVF, this study highlights the importance of asking detailed questions about the evidence supporting any recommended add-on and understanding that additional treatments may not improve outcomes. If you choose to pursue acupuncture, seek a qualified, licensed acupuncturist with specific training and experience in fertility support.

This national Australian survey (n=1,590) investigated IVF add-on utilization among women who underwent treatment between 2017-2020. Results demonstrated an 82% prevalence of add-on use, with acupuncture, preimplantation genetic testing for aneuploidy (PGT-A), and Chinese herbal medicine being most common. Approximately 54% of participants learned about add-ons from fertility specialists, with 72% incurring additional costs. Despite patients reporting high importance placed on scientific evidence for safety and efficacy, 49% assumed add-ons were evidence-based and safe. Decision regret was reported by 66% overall, increasing to 83% among women with unsuccessful IVF outcomes and 75% among those perceiving specialists had greater influence on add-on decisions. The study reveals a significant evidence-practice gap, suggesting patients receive inadequate information about the limited scientific support for most IVF add-ons. Clinical implication: Acupuncturists should provide evidence-based counseling regarding fertility treatment adjuncts and maintain realistic expectations about potential outcomes when treating IVF patients.