This article is for general educational purposes only and does not constitute medical advice. Evidence on IVF add-ons keeps evolving, and suitability depends on your individual diagnosis. Please consult a qualified fertility specialist before choosing any treatment.
Somewhere in the middle of an IVF plan, many couples are offered “extras”: a scratch of the uterine lining, a special embryo glue, an infusion, a test. They sound helpful, and they often cost extra. The honest question is whether they actually raise your chance of a baby. Here is what the evidence says, in plain words.
The Core Fact
IVF itself is the proven treatment. Add-ons are optional extras, and for most of them the evidence is limited, mixed or still being studied. A few may help specific patients, but none is a guaranteed boost.
What Is Endometrial Scratching?
The procedure —
A thin plastic tube is passed through the cervix and gently moved to disturb the uterine lining. It is the same as an endometrial biopsy, takes about five minutes, usually needs no anaesthetic, and is often done in the cycle before embryo transfer.
The idea behind it —
The small injury may trigger healing and release immune signals and growth factors that help an embryo implant. It is a reasonable theory, but it has not been proven in practice.
Does It Work? What the Trials Show
A recent review of randomised trials found that scratching may slightly raise the chance of pregnancy and live birth, in the range of a few extra births per 100 people. But the quality of evidence was only moderate, results across studies conflict, and some of the largest trials found no benefit. It made no difference to miscarriage risk.
Worth knowing: most failed implantations are due to chromosomal problems in the embryo rather than the uterine lining, so scratching cannot be expected to fix most cases. It is usually considered only after repeated implantation failure.
Risks and Discomfort
Pain
Studies report moderate discomfort, around 4 out of 10 on average, similar to a smear test but more uncomfortable.
Rare Complications
Prolonged bleeding, infection and, very rarely, uterine injury. Avoid unprotected intercourse in the scratch cycle, as advised by your doctor.
Other Common Add-Ons at a Glance
Names and availability differ between clinics, so ask your own doctor about each one.
| Add-On | What It Is | Where the Evidence Stands |
|---|---|---|
| Embryo glue | A medium rich in hyaluronan used during transfer | Some studies suggest a small benefit; findings are not consistent |
| Time-lapse imaging | Embryos photographed continuously in the incubator | Helpful for observation; no clear proof of higher birth rates |
| Assisted hatching | A tiny opening made in the embryo's outer shell | May be considered in selected cases; not shown to help everyone |
| PGT-A (embryo screening) | Checks embryos for chromosome numbers | Useful in selected situations; not proven for all patients |
| Intralipid or immune treatments | Infusions or medicines aimed at the immune system | Evidence is limited and unclear |
| Endometrial scratching | Gentle injury to the uterine lining | Possible small benefit; results conflict |
Myth: The more add-ons you pick, the better your chance.
Fact: Extras do not stack up like vitamins. Each adds cost and sometimes risk, and many have little proof. Basic good-quality IVF done well still matters most.
Offered an Add-On and Unsure?
Bring your reports and we will explain whether it makes sense for you.
Questions to Ask Before Paying for an Add-On
Is it right for my diagnosis?
An add-on that suits one patient may do nothing for another. Ask why it is being suggested for you specifically.
What does the evidence say?
Ask for the research behind it, and whether it comes from randomised trials.
What are the risks and the cost?
Understand what it adds to your bill and whether that money might be better kept for another IVF cycle.
A good add-on is one that is matched to your reason for needing it, not one that is simply on the menu.
A Balanced Way to Decide
Add-ons are not scams, and they are not magic. For some patients, such as those with repeated implantation failure, a trial of one may be reasonable after an honest conversation. For most first-time patients, the better use of time and money is a well-run IVF cycle with good embryo quality and careful transfer.
A thought for couples: if a treatment sounds too good to be true during a vulnerable time, pause and ask for the evidence. A caring doctor will welcome the question.
Frequently Asked Questions
1. Does endometrial scratching improve IVF success?
It may slightly improve the chance of pregnancy in some studies, but results are mixed and some large trials found no benefit. It is not a proven boost for everyone.
2. Is endometrial scratching painful?
It causes moderate discomfort, similar to a smear test but a little stronger, and lasts only a few minutes. Serious complications are rare.
3. Who should consider endometrial scratching?
It is mostly discussed for women who have had repeated implantation failure. Your doctor will decide whether it suits your history.
4. Are IVF add-ons worth the extra cost?
Only if they are matched to your situation and supported by evidence. For many patients, funding another well-run IVF cycle is a better use of money than several unproven extras.
5. What should I ask my doctor before agreeing to an add-on?
Ask why it is recommended for you, what evidence supports it, what the risks are, and what it costs. A clear answer to each is a good sign.
- Get an Honest Second Opinion
We will help you decide which extras, if any, are worth considering for your case.