IVF News

A new analysis published in The Lancet Obstetrics, Gynaecology & Women’s Health has brought renewed attention to one of the most persistent questions in fertility treatment: which IVF add-ons genuinely improve outcomes, and which are simply being offered ahead of the evidence?

IVF add-ons are additional procedures, medicines, tests or laboratory techniques offered alongside standard IVF with the aim of improving the chance of pregnancy or live birth. They have become increasingly visible over the past decade, particularly in private fertility care, where patients may be offered multiple optional extras during an already expensive and emotionally demanding treatment process.

The University of Melbourne-led review examined evidence for ten widely used IVF add-ons. These included preimplantation genetic testing for aneuploidy, endometrial receptivity testing, corticosteroids, EmbryoGlue, endometrial scratching, physiological intracytoplasmic sperm injection, platelet-rich plasma injection into the ovary, platelet-rich plasma infusion into the uterus, acupuncture and intralipids.

The conclusion was careful but important. The review found weak evidence of possible benefit for three add-ons: EmbryoGlue, endometrial scratching and physiological ICSI. For the other seven, the evidence showed either no effect on fertility outcomes or remained inconclusive because of limited or low-quality data.

This distinction matters. The study did not suggest that every add-on is harmful or that every clinical use is inappropriate. Rather, it highlighted that availability is not the same as proven benefit. For patients, the presence of an add-on on a clinic menu can understandably feel like an endorsement. For clinicians and laboratories, the study is a reminder that treatment options should be explained with the same precision used in the laboratory: what is known, what is uncertain and what has not yet been demonstrated.

One of the strengths of the review was its attention to study trustworthiness. Of 157 potentially eligible trials, 72 were excluded because of trustworthiness concerns. The final analysis pooled data from 85 trials considered suitable for inclusion. This is an important point for reproductive medicine, where small studies, heterogeneous patient groups and variable outcome measures can make it difficult to draw reliable conclusions.

The add-ons with no clear evidence of benefit included several that are widely discussed by patients online, such as acupuncture, corticosteroids, intralipid infusion and platelet-rich plasma treatments. The review also placed endometrial receptivity testing and preimplantation genetic testing for aneuploidy in the group where benefit was not clearly demonstrated in the assessed evidence. That finding is likely to attract attention because some of these technologies are well known, technically sophisticated and commonly promoted.

For embryology and IVF laboratory teams, the findings are especially relevant because some add-ons sit close to routine lab practice. EmbryoGlue, for example, is a transfer medium containing hyaluronic acid. Physiological ICSI, or PICSI, selects sperm based on hyaluronic acid binding. These techniques are biologically plausible, and the review found weak evidence of possible benefit, but the language remains cautious. Weak evidence is not the same as strong proof, and possible benefit still requires careful discussion of patient selection, cost, expected effect size and uncertainty.

The second Lancet paper focused on patient information. Researchers evaluated an Evidence-based IVF website designed to provide balanced information about add-ons. The trial found that patients who used the evidence-based resource had a better understanding of benefits, risks and evidence quality compared with people exposed to typical online information. This is a useful finding in itself. In IVF, patients often make decisions under time pressure, emotional strain and financial pressure. Clearer information may not make those decisions easy, but it can make them more informed.

The broader message is not anti-innovation. IVF has always progressed through technical refinement, careful observation and clinical research. Many practices that are now routine began as experimental improvements. The issue is how quickly innovations move from possibility to paid intervention, and whether patients are told clearly when evidence is preliminary, absent or uncertain.

Good fertility care should leave room for innovation while protecting patients from overstatement. That means separating experimental use from established practice, avoiding implied promises, and ensuring that consent conversations include uncertainty, risks, costs and realistic expectations. It also means recognising that patients may feel they must try everything, particularly after failed cycles. In that setting, even small claims can carry significant emotional weight.

For clinics, this review may encourage a more disciplined approach to add-ons. Some may choose to stop offering add-ons with little supporting evidence. Others may continue to offer selected interventions in clearly defined circumstances, but with stronger consent language and better documentation. For researchers, the review points to the need for larger, rigorous, well-designed trials that measure outcomes patients actually care about, especially live birth.

For patients, the practical message is simple: ask what evidence supports the add-on, whether it has been shown to improve live birth rates, whether the evidence applies to your specific clinical situation, what the risks and costs are, and what would happen if you chose not to use it.

For the IVF field, this is a useful moment of recalibration. The science of assisted reproduction continues to advance, but progress depends on evidence, transparency and trust. Add-ons should earn their place in treatment through reliable data, not through hope alone.

Sources

23 June 2026. The Lancet Obstetrics, Gynaecology, and Women's Health

• IVF add-ons: evidence, trust, and what patients are told

23 June 2026. The Lancet Obstetrics, Gynaecology, and Women's Health

• Safety and effectiveness of ten common in-vitro fertilisation add-ons: a systematic review and meta-analysis

23 June 2026. The Lancet Obstetrics, Gynaecology, and Women's Health

• Evaluation of a codesigned resource about in-vitro fertilisation add-ons: an online, parallel-group, single-blinded, randomised trial

24 June 2026. University of Melbourne

• Common IVF extras lack strong evidence of improving fertility, research finds

23 June 2026. The Guardian

• Most IVF 'add-on' treatments have no effect on fertility or remain unproven, study says

23 June 2026. New York Times

• Services sold to boost IVF odds backed by little evidence, study finds

23 June 2026. ABC News Australia

• No evidence most IVF add-on treatments improve fertility

24 June 2026. The Economist

• Do high-tech 'add-ons' increase the chance that IVF will work?

The UK fertility sector has changed substantially over the past three decades. According to the latest data from the Human Fertilisation and Embryology Authority, around 53,000 patients underwent IVF in 2024, compared with around 19,000 in the early 1990s. IVF now accounts for around 1 in 31 UK births, which the HFEA describes as roughly one child in every classroom.

The figures show both the scale of modern fertility treatment and the ways in which practice has evolved. In 2024, around 64,000 patients underwent more than 100,000 treatment and freezing cycles at HFEA-licensed clinics. IVF remained the dominant activity, accounting for 76% of clinic activity. Frozen embryo transfers now make up almost half of all IVF cycles, rising from 24% in 2014 to 48% in 2024.

This shift reflects a broader clinical movement toward embryo freezing, single embryo transfer, and staged treatment pathways. Egg and embryo freezing cycles represented 17% of all cycles in 2024, with embryo freezing accounting for most of this activity. Embryo freezing cycles increased from around 1,900 in 2014 to 10,450 in 2024. Egg freezing has also grown markedly over the last decade, from around 700 patients in 2014 to 5,580 in 2024, although the HFEA notes that egg freezing did not increase year on year for the first time since 2020.

The birth data is equally striking. Around 21,400 babies were born from IVF in the UK in 2024, more than double the number recorded in 2004. IVF births have risen from under 1.4% of all UK births in 2004 to 3.2% in 2024. Most IVF births, 81%, followed treatment using a patient’s own eggs and partner sperm. A further 13% involved a patient’s own eggs and donor sperm, while 5% involved donor eggs and partner sperm.

Success rates have improved over time, but age remains one of the clearest determinants of outcome. The average IVF birth rate per embryo transferred was 30% in 2024. For patients aged 18 to 34, the birth rate per embryo transferred was 38%, compared with 8% for patients aged 43 to 44. The HFEA also reports that average birth rates have improved since 2014, when the rate per embryo transferred was 20%.

At the same time, the report highlights persistent disparities. Among patients aged 18 to 37, Asian and Black patients had average birth rates of 30% per embryo transferred, compared with 36% for White patients and 35% for patients from Mixed ethnic backgrounds. The HFEA notes that its data does not explain the reasons for these differences, which may relate to a range of medical, demographic, social, economic, and other factors.

One of the most positive long-term trends is the fall in multiple births. Multiple pregnancies carry increased risks for patients and babies, including preterm birth, pre-eclampsia, stillbirth, neonatal death, and maternal death. The UK multiple birth rate after IVF fell from 14.4% in 2014 to 3.2% in 2024, one of the lowest rates internationally. This decline has been closely linked to the high use of single embryo transfer, which reached 84% in 2024. Importantly, birth rates have continued to rise while multiple birth rates have fallen.

The data also shows changing patterns in who is using fertility treatment. Opposite-sex couples still accounted for most IVF patients in 2024, at around 47,000 patients. However, the number of female same-sex IVF patients increased from around 1,000 in 2014 to 2,800 in 2024, while single IVF patients more than tripled from 1,100 to 3,700. The Independent highlighted this trend in its coverage, reporting that solo women now represent around 7% of UK IVF patients, up from around 3% in 2014.

This trend appears to be connected with a shift away from donor insemination and toward IVF with donor sperm for some patients. The HFEA notes that single patients and female same-sex couples were historically more likely to try donor insemination first, but increasing numbers are now choosing IVF as a first treatment. Possible reasons include higher birth rates per cycle, shorter time to pregnancy, lower multiple birth rates, donor sperm cost considerations across multiple cycles, and the possibility of storing embryos for future treatment.

Funding remains a central issue. NHS-funded IVF cycles declined from 35% of all IVF cycles in 2019 to 28% in 2024 across the UK. The proportion was lowest in England, where NHS funding accounted for 25% of IVF cycles. This means more patients are self-funding treatment at a time when demand is increasing and the patient population is becoming broader.

For laboratories and clinics, the HFEA’s 2024 data tells a clear story. IVF is no longer a niche treatment pathway. It is a major part of reproductive healthcare, supporting a growing and increasingly diverse group of patients. Clinical practice has become safer, more refined, and more reliant on cryopreservation, while the sector continues to face important questions about access, equity, and long-term capacity.

For scientists, embryologists, and laboratory teams, these figures reinforce the importance of robust systems, consistent quality control, validated cryostorage, careful embryo handling, and high-quality patient data. As IVF activity continues to grow, the laboratory remains central to both clinical outcomes and patient trust.

Sources

16 June 2026. Human Fertilisation and Embryology Authority

• Number of IVF patients triples in 30 years, says fertility regulator

16 June 2026. Human Fertilisation and Embryology Authority

• Fertility treatment 2024: trends and figures

17 June 2026. The Independent

• Number of single women undergoing IVF has tripled over the past decade

Training Batch Schedule July 2026

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The International School of Embryology a unit of Chennai Fertility Centre and Research Institute was established to offer training in Advanced Reproductive Techniques and Embryology for clinicians and embryologists. It will help them to know in-depth knowledge and have good hands-on training. The members of our teaching faculty aim to bring Clinician and Embryologists to the highest level of knowledge about Assisted Reproductive Technology and practical capability.

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A 27-year-old man has produced sperm from testicular tissue that was removed and frozen when he was 10 years old, before he underwent chemotherapy and stem cell transplantation for sickle cell disease. The case is being described as a first-in-human proof of concept for a fertility preservation strategy that has been discussed for decades, but until now had not been shown to restore spermatogenesis in an adult patient using tissue banked before puberty.

The work, led by researchers at Vrije Universiteit Brussel in collaboration with Brussels IVF at University Hospital Brussels, addresses one of the most difficult problems in male fertility preservation. Adult males and post-pubertal adolescents can often bank sperm before chemotherapy, radiotherapy, or other gonadotoxic treatment. Prepubertal boys cannot. They do not yet produce mature sperm, which means the only realistic fertility preservation option is to cryopreserve immature testicular tissue containing spermatogonial stem cells, with the hope that future technologies will be able to use that tissue to restore fertility.

That future has now become more tangible. In 2008, before receiving conditioning therapy with busulfan and cyclophosphamide for haematopoietic stem cell transplantation, one testis was surgically removed from the patient, divided into small fragments, and cryopreserved. Histology at the time confirmed preserved tubular architecture and the presence of spermatogonia. Years later, as an adult, the patient presented with persistent azoospermia between 2022 and 2024, meaning there was no sperm in his ejaculate. In December 2024, frozen-thawed testicular fragments were transplanted back to the patient.

The approach was autologous, meaning the tissue came from the same individual, avoiding the immunological complexity of donor tissue. Eleven fragments of immature testicular tissue were thawed. The researchers grafted tissue to both intra-testicular and subcutaneous scrotal sites, creating two biologically distinct environments for the transplanted fragments. Over the following year, they monitored recovery, graft survival, vascularization, hormone profiles, and semen parameters. After one year, the grafts were surgically retrieved and analyzed.

The most important finding was that spermatogenesis was detected in intra-testicular grafts. Histological analysis showed intact tubular architecture and maturation of somatic cells across the grafts. Spermatogonial stem cells and evidence of active spermatogenesis were identified in two of the four intra-testicular grafts. By contrast, no germ cells were detected in the subcutaneous scrotal grafts, which appeared more fibrotic. This distinction is scientifically important because it suggests that the adult testicular environment may provide signals or structural support that are not replicated when the tissue is placed under the scrotal skin.

The study also reported sperm recovery from the graft tissue itself. Enzymatic digestion was needed to retrieve spermatozoa, because the transplanted fragments were not connected to the excurrent duct system. In practical terms, this means the sperm would not be expected to appear naturally in the ejaculate, and natural conception would not be the likely route. Instead, any reproductive use would probably require surgical or laboratory recovery of sperm followed by assisted reproduction, most likely ICSI.

The case does not yet show that the recovered sperm can fertilize an oocyte or result in pregnancy. That distinction matters. Producing morphologically recognizable sperm and demonstrating active spermatogenesis is a major biological step, but reproductive competence still has to be proven. The patient is reportedly considering whether to undergo a second round of grafting to obtain more sperm or proceed toward IVF treatment with the sperm that has already been collected and frozen.

For the field of fertility preservation, the result is still highly significant. Testicular tissue cryopreservation has been offered by some centers for boys facing high-risk gonadotoxic treatment, but for many years it has been a promise made under uncertainty. Families were told that tissue could be banked, but that future fertility restoration could not be guaranteed. This report begins to close that gap. It shows that immature human testicular tissue can survive long-term cryostorage, revascularize after transplantation, and support spermatogenesis in vivo after being returned to the patient many years later.

The timeline is also notable. The tissue was frozen in 2008 and transplanted 16 years later. That duration gives confidence that long-term storage itself may not be the central limitation, provided the tissue is collected, processed, cryopreserved, and stored appropriately. For patients whose tissue is already banked, this is a particularly meaningful point. The earliest cohorts from testicular tissue banking programs are now reaching adulthood, and some are beginning to consider fertility options.

The clinical context is broader than cancer. Gonadotoxic treatment is most often discussed in relation to childhood cancer therapy, but this case involved sickle cell disease treated with high-dose chemotherapy and stem cell transplantation. Many childhood conditions require therapies that can damage or destroy future fertility. For prepubertal boys, testicular tissue banking may be the only fertility preservation option available before treatment begins.

There are still important limitations. This is a single case, and the results are currently reported in a preprint that has not yet completed peer review. The number of sperm recovered was limited, semen parameters did not significantly change during follow-up, and the successful spermatogenic activity was restricted to intra-testicular grafts. The safety profile also requires ongoing attention, especially for patients treated for malignancy, where reintroducing tissue may carry a theoretical risk of reintroducing malignant cells. That concern may vary depending on the original diagnosis and will remain central to patient selection.

Even with these cautions, the study changes the conversation. It suggests that prepubertal testicular tissue banking is not only a speculative preservation strategy but may become part of a real fertility restoration pathway. For reproductive scientists, the case reinforces the biological potential of spermatogonial stem cells and the importance of the testicular niche. For clinicians, it highlights the need to identify eligible patients before treatment begins, because the opportunity to collect tissue exists only before gonadotoxic therapy has done its damage.

For IVF laboratories, the downstream implications are also worth watching. If this approach becomes more widely adopted, the recovered sperm will likely be rare, surgically obtained, and precious. Handling, cryostorage, sperm identification, ICSI workflows, and chain-of-custody procedures will all need to be carefully adapted to the clinical reality of extremely limited gamete material. As with other forms of fertility preservation, laboratory precision will be central to translating the biological breakthrough into reproductive outcomes.

The most measured interpretation is that this is not yet a complete fertility restoration treatment. It is, however, a first human demonstration that the central biological mechanism can work. Tissue frozen before puberty can survive, can be returned to the adult body, and can generate sperm. For families who consented to tissue banking years ago without any guarantee that it would ever be usable, that is an important and hopeful development.

Sources and References

4 May 2026. The Guardian

• Man produces sperm from testicular tissue frozen as a child in breakthrough trial

12 March 2026. MedRxiv

• First successful transplant of human immature testicular tissue after gonadotoxic therapy during childhood: complete spermatogenesis in intra-testicular grafts

6 May 2026. IFL Science

• First-ever transplant of testicular tissue frozen for nearly 20 years found to produce sperm

Training Batch Schedule June 2026

Batch - VI :    01st  to 15th  June 2026

The International School of Embryology a unit of Chennai Fertility Centre and Research Institute was established to offer training in Advanced Reproductive Techniques and Embryology for clinicians and embryologists. It will help them to know in-depth knowledge and have good hands-on training. The members of our teaching faculty aim to bring Clinician and Embryologists to the highest level of knowledge about Assisted Reproductive Technology and practical capability.

Our courses cover basics in Andrology, Embryology, ICSI & Cryosciences (Hands-on).

Limited Seats. For admission Contact  9003111598 / 8428278218