Fertility regulator survey reveals widespread use of IVF add-ons

Almost three-quarters of UK fertility patients used a treatment 'add-on', according to the Human Fertilisation and Embryology Authority (HFEA)'s National Patient Survey 2024.

Published in March 2025, the survey, which ran from September to October 2024, obtained many insights into the experience and views of 1500 UK fertility patients. It is the third of its kind following similar surveys in 2021 and 2018 (see BioNews 1141 and 965). Additional tests, treatments or emerging technologies were used by 73 percent of respondents, however very few of these add-ons have been shown to increase patients' chances of becoming pregnant.

'It is disappointing to see a significant number of patients are still using add-ons and emerging technologies,' said HFEA chair Julia Chain.

Fertility patients' satisfaction with their most recent treatment remained generally consistent across the three surveys (71–74 percent). However, the 2024 survey showed patient satisfaction was much lower for Asian (50 percent) and Black (59 percent) patients. Add-ons – optional, non-essential and often expensive – were used by patients in addition to proven fertility treatments such as IVF and intrauterine insemination. Emerging technologies also include the use of artificial intelligence tools.

Of the add-ons available, additional medications/supplements were used most (39 percent), followed by acupuncture (27 percent) and time-lapse imaging (26 percent). Patients undergoing one cycle were less likely to have used an add-on or emerging technology than those who underwent five or more cycles (62 vs 86 percent), and NHS-funded patients were also less likely to have used them compared with private patients (57 vs 76 percent).

The survey also identified changes in the use of two add-ons. Endometrial scratching, used to 'scratch' the lining of the womb prior to embryo implantation, decreased from 24 percent in 2018 to ten percent in 2024. However, use of pre-implantation genetic testing for aneuploidy (PGT-A) in embryos, rose from seven percent in 2021 to 13 percent in 2024.

The survey also revealed that 52 percent of patients used an add-on or emerging technology after their clinic explained its effectiveness, with 59 percent of patients choosing to use one based on their clinic's recommendation. This was commonly due to the clinic stating that the treatment would increase the chance of having a baby (44 percent).

However, only 37 percent of patients said their clinic explained the potential risks of using an add-on or emerging technology, similar to the findings of the 2021 survey, and 28 percent of patients who used an add-on or emerging technology did not understand why it was used.

'It is particularly disappointing that only half of patients had the effectiveness explained to them, let alone the risks. We regularly remind clinics that, according to our Code of Practice, they must give patients a clear idea of what any treatment add-on involves, how likely it is to increase their chance of a successful pregnancy, cost, risks, and link to our public ratings system. We will continue to remind clinics about improving clarity and communication for patients,' said Chain.