“Add-ons” have attracted attention lately as international authorities have made announcements about restricting access to “add-ons”.

So what is an “add-on”?

An add-on is an extra treatment or service which is added to standard medical care, usually at an extra cost. Add-ons may have little or no medical evidence.

Evidence to support new interventions evolves over time and some IVF clinics and doctors adopt new treatments early in the evolution of evidence and some delay until incontrovertible proof of benefit.

Some people consider that offering an add-on to a vulnerable group such as couples experiencing infertility is unethical. At Care Fertility we do offer add-ons, but only when preliminary evidence suggests benefit.

This preliminary evidence is always described in an information sheet with a clear description of the potential risks, benefits and out of pocket costs. Sometimes the preliminary evidence is confirmed as beneficial and sometimes not. When new evidence becomes available that an add-on is not beneficial, Care Fertility will no longer offer that service. Endometrial scratch is an example of this.

On some occasions when there is uncertainty about benefit of an add-on, Care Fertility will offer the treatment as part of a randomised clinical trial. There is generally no charge for the treatment and informed consent is sought after approval of the Human Research and Ethics committee. Some examples of trials Care Fertility has performed include investigating the role of acupuncture in IVF and fallopian sperm perfusion at the time of intrauterine insemination.

It’s also important to remember that freezing and transferring embryos were once “add-ons” and are now mainstream practice which have resulted in many children being born. Before using an add-on it is important that you read the information sheet carefully, ask questions of your doctor and discuss your choice with your partner.

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