IVF add-ons: effectiveness, efficiency, safety, and additional costs - A position statement by the SIFES-MR.

Area of Science:

• Reproductive Medicine
• In Vitro Fertilization (IVF)

Background:

• IVF add-ons are adjuncts to standard procedures.
• Their efficacy, safety, and cost-effectiveness vary significantly.
• Evidence-based selection is crucial for patient care.

Purpose of the Study:

• To critically appraise IVF add-ons.
• To provide recommendations based on current evidence and expert consensus.
• To guide clinical practice and patient counseling.

Main Methods:

• Multidisciplinary expert panel consensus over two years.
• Revision of international guidelines (ESHRE, HFEA, ISAR, ASRM).
• Literature review and Delphi consensus workflow.

Main Results:

• Preimplantation genetic testing for aneuploidies (PGT-A) shows potential in select populations.
• Other add-ons lack sufficient evidence or raise safety concerns.
• Endometrial receptivity testing and mtDNA load measurement are not recommended.

Conclusions:

• Emphasize evidence-based practice in assisted reproductive technology (ART).
• Highlight the need for clear patient communication and counseling.
• Advocate for further research and regulatory oversight for IVF add-ons.