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Chapter 8 - Adjuvants in Assisted Reproduction

Published online by Cambridge University Press:  25 February 2021

By
Sarah Armstrong  and
Cynthia Farquhar
Edited by
Siladitya Bhattacharya  and
Mark Hamilton
Siladitya Bhattacharya
Affiliation:
University of Aberdeen
Mark Hamilton
Affiliation:
University of Aberdeen
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Summary

In this chapter, the evidence and use of in vitro fertilisation (IVF) add-ons in the UK is explored. In addition, the stance of professional and regulatory bodies is described. The term ‘add-on’ has been coined to describe the additional ‘extras’ to a routine or intracytoplasmic sperm injection cycle that are commonly offered to those undergoing treatment with the aim of improving livebirth rates. A summary of the highest quality available evidence for the following add-ons is presented: endometrial scratching; time-lapse imaging; assisted hatching; preimplantation genetic testing (PGT-A); endometrial receptivity array; GM-CSF containing culture media; Embryo Glue (hyaluronic acid); artificial egg activation with calcium ionophore; intracytoplasmic morphologically selected sperm injection (IMSI); physiological intracytoplasmic sperm injection (PICSI); sperm DNA test; and reproductive immunology procedures. There remains a paucity of evidence to support the routine use of add-ons based on the available randomised controlled trial and systematic review evidence. This is particularly important given that most patients pay additional fees to utilise add-ons. In order for patients to receive high- quality care in IVF clinics, clinicians must be prepared to discuss the relevant evidence regarding efficacy and safety of the specific add-on being considered.

Keywords

add-onsin vitro fertilisationintracytoplasmic sperm injectionadjunctsefficacysafetyinformed consentmedical ethics
Type
Chapter
Information
Reproductive Medicine for the MRCOG , pp. 82 - 92
Publisher: Cambridge University Press
Print publication year: 2021

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References

Lensen, S, Osavlyuk, D, Armstrong, S, Stadelmann, C, Hennes, A, Napier, E, et al. A randomized trial of endometrial scratching before in vitro fertilization. N Engl J Med. 2019;380(4):325–34.CrossRefGoogle ScholarPubMed
Metwally MC, R; Pye, C; Dimairo, M; White, D; Walters, S; Cohen, J; Chater, T; Pemberton, K; Young, T; Lomas, E; Taylor, E; Laird, L; Mohiyiddeen, L; Cheong, Y. Endometrial scratching in women undergoing their first In Vitro Fertilisation (IVF) cycle: results from the UK Multicentre Endometrial Scratch Randomised Controlled Trial. ESHRE: Human Reproduction; 2020. p. i140.Google Scholar
Van Hoogenhuijze, N. Torrance, H.L.; Eijkemans, M.J.C.; Broekmans, F.J.M. (2020). Twelve-month follow-up results of a randomized controlled trial studying endometrial scratching in women with one failed IVF/ICSI cycle (the SCRaTCH trial). ESHRE: Human Reproduction; 2020.Google Scholar
Cochrane. Cochrane Library 2019. Available at: www.cochranelibrary.comGoogle Scholar
Taguchi, S, Funabiki, M, Hayashi, T, Tada, Y, Iwaki, Y, Karita, M, et al. The implantation rate of Japanese infertile patients with repeated implantation failure can be improved by endometrial receptivity array (era) test: a randomized controlled trial. Fertil Steril. 2018;110(4):e90.CrossRefGoogle Scholar
Simon, C, Vladimirov, IK, Castillon Cortes, G, Ortega, I, Cabanillas, S, Vidal, C, et al. Prospective, randomized study of the endometrial receptivity analysis (ERA) test in the infertility work-up to guide personalized embryo transfer versus fresh transfer or deferred embryo transfer. Fertil Steril. 2016;106(3):e46-e7.CrossRefGoogle Scholar
Siristatidis, C, Vogiatzi, P, Salamalekis, G, Creatsa, M, Vrachnis, N, Glujovsky, D, et al. Granulocyte macrophage colony stimulating factor supplementation in culture media for subfertile women undergoing assisted reproduction technologies: a systematic review. Int J Endocrinol. 2013;2013:704967.CrossRefGoogle ScholarPubMed
Sfontouris, IA, Anagnostara, K., Kolibianakis, EM, Lainas, TG. Effect of granulocyte-macrophage colony-stimulating factor (GM-CSF) on pregnancy rates in patients with multiple unsuccessful IVF attempts. Hum. Reprod. 28(Suppl 1):i60–i62.Google Scholar
Fancsovits, P, Lehner, A, Murber, A, Kaszas, Z, Rigo, J, Urbancsek, J. Effect of hyaluronan-enriched embryo transfer medium on IVF outcome: a prospective randomized clinical trial. Arch Gynecol Obstet. 2015;291(5):1173–9.CrossRefGoogle ScholarPubMed
Sfontouris, IA, Nastri, CO, Lima, ML, Tahmasbpourmarzouni, E, Raine-Fenning, N, Martins, WP. Artificial oocyte activation to improve reproductive outcomes in women with previous fertilization failure: a systematic review and meta-analysis of RCTs. Hum Reprod. 2015;30(8):1831–41.CrossRefGoogle ScholarPubMed
Majumdar, G, Majumdar, A. A prospective randomized study to evaluate the effect of hyaluronic acid sperm selection on the intracytoplasmic sperm injection outcome of patients with unexplained infertility having normal semen parameters. J Assist Reprod Genet. 2013;30(11):1471–5.CrossRefGoogle ScholarPubMed
Kirkman-Brown, J, Pavitt, S, Khalaf, Y, Lewis, S, Hooper, R, Bhattacharya, S, et al. Sperm selection for assisted reproduction by prior hyaluronan binding: the HABSelect RCT. Efficacy and Mechanism Evaluation. Southampton, UK: NIHR Journals Library, 2019.Google Scholar
Cissen, M, Wely, MV, Scholten, I, Mansell, S, Bruin, JP, Mol, BW, et al. Measuring sperm DNA fragmentation and clinical outcomes of medically assisted reproduction: a systematic review and meta-analysis. PLoS ONE. 2016;11(11):e0165125.CrossRefGoogle ScholarPubMed
Li, J, Chen, Y, Liu, C, Hu, Y, Li, L. Intravenous immunoglobulin treatment for repeated IVF/ICSI failure and unexplained infertility: a systematic review and a meta-analysis. Am J Reprod Immunol. 2013;70(6):434–47.CrossRefGoogle ScholarPubMed
Achilli, C, Duran-Retamal, M, Saab, W, Serhal, P, Seshadri, S. The role of immunotherapy in in vitro fertilization and recurrent pregnancy loss: a systematic review and meta-analysis. Fertil Steril. 2018;110(6):1089–100.CrossRefGoogle Scholar

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