Watchdog to Fertility Clinics: Drop Unproven ‘Add‑Ons’ — The Evidence Patients Should Demand Before Paying More
A national watchdog has sent a clear signal to fertility providers: stop selling hope without proof. Draft guidance from the National Institute for Health and Care Excellence (NICE) urges both NHS and private clinics to drop in‑vitro fertilisation (IVF) “add‑ons” that lack high‑quality evidence of benefit. The committee’s rationale is blunt: optional tests and procedures that promise higher success rates can inflate costs, add risk and discomfort, and distract from care that actually improves live births. Add‑ons are marketed on top of standard IVF protocols and can include endometrial scratching, pre‑transfer hysteroscopy, endometrial receptivity tests, and the routine use of intracytoplasmic sperm injection (ICSI) when semen parameters are normal. Many are time‑sensitive, invasive, and costly; most have not demonstrated clear live‑birth gains in the populations where they’re heavily marketed. Patients’ vulnerability is not hypothetical. The fertility regulator’s survey found that nearly three‑quarters of people who had treatment in late 2024 used additional tests or emerging technologies despite most not being proven to work; only about a third reported that risks were explained. In this landscape, NICE’s call for transparent counseling and evidence‑led care is a timely reset for clinics and consumers alike.