IVF Add-Ons 101: What the Research Really Says About the Most Common Options

When going through IVF, there’s already so much to take in: medications, monitoring, procedures, emotions. On top of all that, many patients are offered optional “add-ons.” These are extra tests, technologies, or lab techniques that clinics may recommend to boost success rates, improve safety, or personalize treatment.

But here’s the catch: some add-ons are supported by strong scientific evidence, while others are still considered experimental. That can leave people wondering what’s truly worth considering. Let’s break it down in plain language.

What are the add-on treatments for IVF?

IVF add-ons can be grouped into a few main categories:

• Embryo culture and monitoring tools: Methods that help embryos grow or allow doctors to assess them more closely.
• Endometrial testing: Tests that evaluate the uterine lining to identify issues that might affect implantation.
• Laboratory techniques: Special procedures used during fertilization or embryo transfer.
• Tracking and safety systems: Technologies that reduce errors in the IVF lab and bring peace of mind.

Not every patient needs (or benefits from) every add-on, but understanding what’s available can help guide more empowered conversations with your doctor.

Here are each of the most popular add-on treatments, so you can decide which are best for your IVF journey:

EmbryoGlue

EmbryoGlue is a solution used during embryo transfer that includes hyaluronan, something your body naturally makes in the reproductive tract. The idea is that it gives the embryo a stickier, more welcoming environment to latch onto, which may help boost the chances of implantation.

A 2020 Cochrane review of more than 6,700 participants found moderate-quality evidence that hyaluronan increases the likelihood of live birth and may slightly reduce miscarriage risk, though results for miscarriage were less conclusive. While it’s not a guarantee, EmbryoGlue is one of the few IVF add-ons with evidence suggesting a real benefit and no adverse effects.

EmbryoScope

Embryo monitoring tools, like EmbryoScope, use time-lapse imaging to continuously capture embryo development without disturbing them. Instead of checking embryos under a microscope at specific points, embryologists get a detailed “movie” of growth patterns. Ultimately, it means embryologists can select embryos with more precision.

The research is still evolving, but growing evidence suggests that time-lapse monitoring can support healthier embryo development, leading to more embryos reaching the blastocyst stage and a higher number of usable embryos compared to standard incubators.

EMMA (Endometrial Microbiome Metagenomic Analysis)

EMMA looks at the combination of both good and bad bacteria in the uterine lining. Ideally, the environment is pathogen-free and dominated by good bacteria like Lactobacillus, which are thought to support implantation. If the balance is off, something called dysbiosis, it may make it harder for an embryo to implant.

For people who’ve been through repeated implantation failure (RIF), EMMA is sometimes offered to see if the uterine microbiome could be playing a role. Some studies do suggest a link between dysbiosis and lower pregnancy rates, but the evidence isn’t clear-cut yet. That means EMMA isn’t necessarily recommended across the board, but it could be useful in certain situations where other answers are hard to find.

ALICE (Analysis of Infectious Chronic Endometritis)

ALICE is a test that checks for chronic endometritis, a subtle, often symptom-free inflammation in the uterus that’s usually tied to bacterial infection. Research suggests this condition may affect up to 30% of people with infertility, and as many as 60% of those with RIF.

In one study, patients with RIF who had EMMA and/or ALICE testing and received targeted treatment, like antibiotics or probiotics, had much higher pregnancy rates compared to those who went ahead without testing. More large-scale studies are still needed, but the findings suggest that identifying and treating hidden infections could be an important step for some people facing repeated IVF setbacks.

ERA (Endometrial Receptivity Analysis)

ERA (Endometrial Receptivity Analysis) is a test that looks at the genetic expression of the uterine lining to determine the “window of implantation,” the brief time when the uterus is most receptive to the introduction of an embryo. For some people, this window may not line up with the standard timing used in IVF. ERA aims to identify the personalized embryo transfer time so that the embryo transfer is performed at the optimal moment for each individual.

While research is still mixed on whether ERA improves live birth rates for everyone, some studies suggest it may be helpful in cases of repeated implantation failure. That’s why certain clinics recommend it as part of a more tailored approach. For patients who’ve had multiple unsuccessful transfers, ERA can offer additional insight and a sense of control when looking for answers.

eWitness

IVF labs are high-stakes environments, and understandably, patients want reassurance that their embryos are handled safely. eWitness is an electronic witnessing system that uses barcodes or RFID tags to track samples, ensuring protocols and witnessing are documented.

While eWitness doesn’t directly improve pregnancy rates, it offers peace of mind, something that can be just as valuable when navigating the stress of IVF.

Do IVF add-ons really improve success rates?

Research shows that not all IVF add-ons work the same way for everyone. A 2022 global review found that while some add-ons show promise, the benefits are often strongest in specific situations rather than across the board.

The encouraging part? Certain add-ons, like EmbryoGlue or advanced embryo monitoring, now have growing evidence to support their use, and others may be helpful in select cases such as repeated implantation failure. The key is having open conversations with your doctor about which options are most relevant to your personal journey, so you can make decisions that feel both informed and empowering.

How can I maximize my IVF success?

The truth is, while add-ons can play a role, the biggest drivers of IVF success are still the core factors: age, egg and sperm quality, and overall health. Think of add-ons as tools that might fine-tune your journey, but the foundation matters most.

Here’s what research consistently shows makes a real difference:

• Lifestyle factors: Small, consistent changes can have a meaningful impact. Eating a nutrient-dense diet, maintaining a healthy weight (whatever that means for you), limiting alcohol, cutting back on caffeine, quitting smoking or vaping, and finding ways to manage stress (through movement, meditation, or therapy) can all support fertility and improve IVF outcomes. Even short walks or regular sleep patterns can help create a more supportive environment for conception.
• Good clinic practices: Not all fertility clinics are the same. Every clinic aims to provide the best possible care, but outcomes can still vary. Factors like lab quality, embryologist expertise, and accreditation standards all play a role in how embryos develop. Taking time to review success rates, understand lab protocols, and feel confident in your clinic’s approach can help you make an informed choice.
• Personalization: IVF isn’t one-size-fits-all. The most effective treatments are tailored to your unique medical history and needs, rather than layering on every test available. For some, personalization might mean adjusting medication doses, timing, or transfer approaches. For others, it could include selective use of add-ons like ERA, EMMA, or EmbryoGlue, when there’s evidence they may be relevant.
• Emotional well-being: IVF can be overwhelming, and emotional health is just as important as physical health. Research suggests that stress alone doesn’t prevent pregnancy, but taking care of your mental health can make the process more manageable. Support groups, therapy, journaling, or simply leaning on trusted friends and family can help lighten the emotional load.
• Partner involvement (if relevant): IVF is often thought of as egg-focused, but sperm health plays a huge role, too. Factors like reducing alcohol, avoiding excessive heat (think hot tubs or saunas), not taking recreational drugs, stopping or reducing how often you’re smoking, managing stress, and eating well can all improve sperm quality, strengthening your chances as a team.

Your fertility journey, your call: Making IVF add-ons work for you

IVF can feel like a maze of choices, and it’s natural to want certainty when so much is at stake. Having the right information and the right tools can turn that uncertainty into confidence.

Vitrolife’s add-ons are designed with one goal in mind: to give patients and clinics more options rooted in science and innovation. By asking about these technologies and how they may fit into your treatment plan, you can take an active role in shaping your path forward.

When clarity meets choice, patients are better equipped to make decisions that feel right, and that’s what truly matters on the road to parenthood.