Add-ons are optional extras that you may be offered on top of your normal fertility treatment , often at additional cost. They're sometimes emerging techniques that may have shown promising results in initial studies, or they may have been around for a number of years but haven't necessarily been proven to improve pregnancy or birth rates. Some clinics may include certain add-ons with their treatment packages as standard whilst others may charge separately.
Examples of add-ons:
Add-ons for eggs, sperm, embryos
Trying to stimulate egg activation with a substance called calcium ionophore which the embryo is treated with.
Fertilising the egg in the lab then transferring the embryo in an intrauterine culture device into the womb where it stays for a few hours during embryo development. It is then removed and the embryo put back in an incubator.
EmbryoGlue contains a substance called hyaluronan, which aims to improve the chance of the embryo implanting in the womb.
Elective freeze-all cycles
Creating embryos then freezing them all so none are transferred in the 'fresh' cycle.
Using acid, lasers or other tools to thin or make a hole in the zona pellucida (the layer surrounding an embryo) in order to try to help the embryo 'hatch'.
Preimplantation genetic testing (PGT)
Checking the genes or chromosomes of the embryos for abnormalities before deciding which embryo to transfer.
Sperm DNA test
Analysing the DNA in sperm for damage.
Embryo culture media containing growth factors (BlastoGen, EmbryoGen)
Adding growth factors to the solution used to bathe the embryo as they grow in the lab.
Intra-cytoplasmic morphologically selected sperm injection (IMSI)
Using a high power microscope to look at the sperm to try to help with selection of the best sperm prior to ICSI.
A solution containing hyaluronic acid to try and help select the best sperm prior to ICSI.
Time-lapse imaging (Embryoscope, Primovision, CAREmaps)
A process that enables many images of the developing embryos to be taken without removing them from the incubator. It also has the ability to help the embryologist decide which is the best embryo to replace.
Medications, including tablets and drips
Intravenous immunoglobulin (IVIG)
A blood product containing antibodies given through a drip to try to help the immune system not to reject an embryo.
Tumour necrosis factor alpha blocking agents
Medicine given either as an injection under the skin or into a vein to try help the immune system not to reject an embryo.
Medicine given through a drip to reduce the activity of NK cells in the immune system to try to improve IVF outcomes.
Quad therapy: aspirin, heparin, progesterone and prednisolone
A combination of medicines to try to help implantation and the early growth of an embryo.
Platelet rich plasma
A blood product infused either into the uterus or injected into the ovaries to try to improve egg quality or the chance of an embryo implantating into the lining of the womb.
Testosterone or androgens (DHEA, androderm patch)
A hormone given to try to improve the number and quality of eggs and embryos.
A procedure carried out before IVF where the lining of the womb is deliberately scratched to try and make the womb lining more receptive to the embryo implanting.
Endometrial receptivity array (ERA)
A genetic test undertaken from a sample of the lining of the womb to try and help with timing of embryo transfer.
The use of herbal medicines to try and improve fertility treatment outcomes.
Inserting small needles into the skin at specific places on the body to try to improve fertility outcomes.