In this episode, Kay takes us through some of the ‘add-ons’ that are offered when you are undertaking IVF treatments. She explores in detail the research and data that is available and explains what each treatment involves. This podcast is an invaluable listen for anyone considering IVF, tune in now. KEY TAKEAWAYS What are Add-ons? HFEA has developed a traffic light system to help people decide about add-on treatments. Green signals the treatment has one or more good quality. Amber signals the treatment has a small or conflicting body of evidence. The Red symbol signals the treatment has no evidence to suggest it is effective or safe. Assisted hatching - Red Before an embryo can implant in the womb it has to break out or ‘hatch’ from its zona pellucida. Assisted hatching involves using acid, lasers or other tools to thin or make a hole in the zona pellucida - helping the embryo to hatch. NICE the national body advising doctors on treatments. says: “Assisted hatching is not recommended because it has not been shown to improve pregnancy rates.” What is Elective freeze all cycles – Amber It’s thought by having all their embryos frozen, women are at lower risk of suffering from ovarian hyperstimulation syndrome, an overreaction to fertility drugs. Some research suggests that pregnancy rates are increased by using frozen embryo transfers and that the risks to mother and baby are lower. Artificial egg activation calcium ionophore – Amber If the egg doesn’t activate, then it won’t develop, egg activation may be stimulated by chemicals added to the embryo in the lab.   In the few studies done to date, egg activation may have improved fertilisation rates in cycles where the egg and sperm have failed previously. Embryo glue - Amber Embryo glue may improve the chance of the embryo implanting in the womb. Research suggests it may increase pregnancy and birth rates by around 10% but further quality studies are needed. Endometrial scratching - Amber The theory is that the scratch procedure triggers the body to repair the site of the scratch, releasing chemicals and hormones that make the womb lining more receptive to an embryo implanting. There have only been a small number of moderate quality studies. Intrauterine culture - Red Intrauterine culture allows the early stages of embryo development to take place within the patient’s womb. There’s currently no evidence to show that intrauterine culture improves birth rates and is safe. Pre-implantation genetic screening - Amber for day 5 embryos, Red for day 3 embryos It involves checking embryos for abnormalities in the number of chromosomes. A cell is removed and tested if done later several cells are tested Some small studies have shown that PGS on day 5 might be helpful in selecting a viable embryo to transfer in younger patients Reproductive immunology tests and treatment - Red Reproductive Immunology looks at how a woman’s immune system reacts when she becomes pregnant. There is no convincing evidence and there are risks attached to these treatments, some of which are very serious. Time-lapse imaging - Amber In IVF, time-lapse imaging is used to help select the embryos most likely to successfully develop into a baby. There have been various studies to try and see if time-lapse imaging can improve birth rates. Initial research has shown some promise. Intracytoplasmic morphologic sperm injection (IMSI) - Red The technique involves using a microscope to view sperm under very high magnification This allows clinics to view detailed images of sperm. The research that has been carried out does not support the use of IMSI over standard treatments. Physiological intracytoplasmic sperm injection (PICSI) - Red PICSI identifies sperm that can bind to HA and these sperms are selected for use in treatment. There have been a number of studies comparing PICSI with standard treatments but there is very little evidence to suggest there is any benefit to using it. BEST MOMENTS ‘Capitalising on the hopes of vulnerable people’ ‘I was given an abundance of information but nothing made it clear what the percentages were’ ‘You’re in the hands of the clinic’ ‘For me how the clinic worked was more important than the data’ ‘People who unfortunately require fertility treatments become their own experts’ ‘They read extensively  about each treatment but this is coupled with being desperate for success so they are open to many treatments’ ‘In the UK the top clinics' success rates vary only by a few percentage points’ ‘Non-evidence based therapies, known as add-ons can cost thousands’ VALUABLE RESOURCES https://itunes.apple.com/us/podcast/ivf-before-and-after-podcast/id1413710507?mt=2 ABOUT THE HOST The IVF Before and After podcast was founded by Kay Dempsey. She created IVF Before and After, after many years spent researching and practising every possible way to conceive with IVF. Kay has created a global community with the use of podcasts she will share the stepping stones to empower your mindset, fuel your body organically and support you along your fertility journey. CONTACT METHOD https://www.instagram.com/ivfbeforeandafter/ https://twitter.com/IVFBEFOREAFTER https://www.facebook.com/IVF-Before-and-After See omnystudio.com/listener for privacy information.