There is much discussion about the effectiveness of the so-called add-ons to IVF treatments. Add-ons are optional extras offered with IVF treatment. Sometimes these can also be applied at an additional cost. These are techniques or products that often appear promising in initial studies, but have not always been proven to provide an additional chance of pregnancy.
The HFEA (Human Fertilization and Embryology Authority) in England has made an overview of the existing add-ons and what has been scientifically proven about them.
They use a color coding where a yellow/orange symbol indicates that there is increasing evidence that appears promising, but where future research is still needed. A red symbol indicates that there is no evidence that the add-on is effective and safe.
The add-ons listed are:
- Assisted hatching,
- egg cell activation,
- elective freeze all,
- embryo glue,
- endometrial scratching,
- intrauterine culture,
- PGS, immunology testing and treatment, timelapse.
In vitro fertilization in humans and the cultivation of human embryos (In vitro Fertilization) is reserved for laboratories that have a permit from the Ministry of Health. IVF laboratories perform procedures on male and female human gametes (in vitro) with the aim of creating viable embryos that can ultimately lead to pregnancy and the birth of a child. As a rule, these laboratories include all preparatory and diagnostic laboratory procedures related to IVF within their scope of work. The Clinical Embryologists associated with these laboratories consider it their task to ensure that the various procedures are carried out responsibly, safely, effectively and in compliance with the legal frameworks. This requires close collaboration with the gynecologists within the IVF centers. In certain sub-areas, help is sought from other specializations (for example clinical genetics and medical microbiology).
The total field of work of Clinical Embryologists can consist of the following sub-fields:
1- Laboratory phase IVF
2- Laboratory phase IUI
3- Semen diagnosis
4- Cryopreservation of gametes and embryos
5- Carrying out biopsies
6- Scientific research
The gynecologist and clinical embryologist both have final professional responsibility. Line responsibility lies (usually) with the head of the department.
The gynecologist is ultimately responsible for the medical technical side of IVF and the guidance of the patient, the clinical embryologist for the laboratory technical side and for the embryo in vitro .
In principle, the gynecologist and clinical embryologist stand side by side within the organization. The reserved action regarding IVF under the BIG Act must be qualified taking into account the responsibilities described here.