Harper, J;
Jackson, E;
Sermon, K;
Aitken, RJ;
Harbottle, S;
Mocanu, E;
Hardarson, T;
... Lundin, K; + view all
(2017)
Adjuncts in the IVF laboratory: where is the evidence for 'add-on' interventions?
Human Reproduction
, 32
(3)
pp. 485-491.
10.1093/humrep/dex004.
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Abstract
Globally, IVF patients are routinely offered and charged for a selection of adjunct treatments and tests or ‘add-ons’ that they are told may improve their chance of a live birth, despite there being no clinical evidence supporting the efficacy of the add-on. Any new IVF technology claiming to improve live birth rates (LBR) should, in most cases, first be tested in an appropriate animal model, then in clinical trials, to ensure safety, and finally in a randomized controlled trial (RCT) to provide high-quality evidence that the procedure is safe and effective. Only then should the technique be considered as ‘routine’ and only when applied to the similar patient population as those studied in the RCT. Even then, further pediatric and long-term follow-up studies will need to be undertaken to examine the long-term safety of the procedure. Alarmingly, there are currently numerous examples where adjunct treatments are used in the absence of evidence-based medicine and often at an additional fee. In some cases, when RCTs have shown the technique to be ineffective, it is eventually withdrawn from the clinic. In this paper, we discuss some of the adjunct treatments currently being offered globally in IVF laboratories, including embryo glue and adherence compounds, sperm DNA fragmentation, time-lapse imaging, preimplantation genetic screening, mitochondria DNA load measurement and assisted hatching. We examine the evidence for their safety and efficacy in increasing LBRs. We conclude that robust studies are needed to confirm the safety and efficacy of any adjunct treatment or test before they are offered routinely to IVF patients.
| Type: | Article |
|---|---|
| Title: | Adjuncts in the IVF laboratory: where is the evidence for 'add-on' interventions? |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1093/humrep/dex004 |
| Publisher version: | https://doi.org/10.1093/humrep/dex004 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Obstetrics & Gynecology, Reproductive Biology, IVF adjuncts, sperm DNA fragmentation, embryo glue, adherence compounds, assisted hatching, PGS, mitochondria load, time-lapse imaging, RCT, live-birth rate, RANDOMIZED CONTROLLED-TRIALS, EMBRYO-TRANSFER, THERAPEUTIC ILLUSION, FIBRIN SEALANT, IMPLANTATION, METAANALYSIS, INFERTILITY, VIABILITY, PREGNANCY, COMMITTEE |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Reproductive Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10067433 |
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