The IVF hormone ‘add-on’ that researchers warn just doesn’t work
A common hormone “add-on” offered to IVF patients has been found to have no benefit to pregnancy success; Treatments sold to improve a woman’s chances of getting pregnant without any clear evidence that they work have raised new concerns.
The study, conducted by researchers at the University of Sydney, Human Reproduction Update Intrauterine administration of human chorionic gonadotropin hormone (known as hCG) before embryo transfer does not increase pregnancy or live birth rates, a study out Tuesday found.
The message for patients and clinicians is clear, said Rui Wang, MD, lead author and academic leader of the Evidence Integration Group at the National Health and Medical Research Council’s clinical research center.
“This supplement does not improve fertility outcomes,” Wang said. “This hormone should not be offered routinely as part of in vitro fertilization treatment.”
Hormone is important in IVF; It acts as a “trigger shot” for egg maturation and is an important indicator of pregnancy.
However, no benefit has been identified when used in intrauterine administration, which involves injecting the hormone directly into the uterus shortly before embryo transfer to increase implantation.
The hormone procedure is used in Australia and parts of the United States, Europe, and Asia, and was introduced as an IVF add-on in the early to mid-2010s to improve implantation.
Previous reviews have reported that intrauterine hCG is one of the most promising IVF add-ons, with significant improvements in pregnancy rates. These findings were widely cited and influenced clinical practice worldwide.
But when the team of researchers looked in detail at the raw data behind these studies, rather than the published results, they found that the claims of positive effects did not stack up, Wang said.
As part of their scientific analysis, the researchers examined 28 randomized trials conducted in various countries that tested intrauterine hCG before embryo transfer and seven high-quality studies involving more than 2,200 IVF patients who met the criteria.
Researchers found that the procedure did not improve live birth rates or clinical pregnancy rates.
“There was no evidence of benefit in any group we analyzed, including fresh or frozen transfers, different embryo stages, or different doses,” Wang said.
Researchers believe this is the tip of the iceberg and points to a broader problem that arises when some treatments and supplements are introduced based on unreliable evidence.
Natalie Pennisi, who was diagnosed with endometriosis in her 30s, has been undergoing fertility treatment for ten years.
She underwent 20 rounds of in vitro fertilization treatments, which took a toll on her body and mental health.
“It changed my life. It changed who I am as a person,” said the 48-year-old, who works in public relations.
Pennisi opted to use add-ons during part of his treatment, after advice from his medical team and after doing his own research, but added that the basis for add-on treatments was so large that it was difficult to tell whether the treatments were effective.
“In my experience, one of the most important aspects of a successful treatment outcome is choosing a fertility specialist you feel comfortable enough to ask all the questions,” she said.
“This gives you the best opportunity to become fully informed about the treatment options available, so together you can decide what is right for you.”
Wang said the findings highlight growing concerns about unreliable or unreliable trial data in women’s health research, especially in areas where evidence is quickly translated into clinical care.
Professor Robert Norman, an expert in reproductive medicine at the University of Adelaide, said there was initially a reasonable basis for testing the effectiveness of hCG, but a growing body of research suggested there was no strong evidence for its use.
“The embryo produces hCG before implantation and therefore communicates with the mother before it is embedded in the uterus, so there was a very logical reason to look after it,” Norman said.
“The other thing about HCG is that it’s very cheap and is one of those drugs you can easily buy at the pharmacy, but many trials have shown that we should probably close the door.”
The use of expensive “add-on” treatments sold to increase a woman’s chances of getting pregnant through in vitro fertilization, with no clear evidence that they work, has been a growing concern for years, he said.
“When it’s expensive, complex and technically difficult… then we’re particularly concerned about that,” he said.
The cost of intrauterine hCG in Australia is generally around $50 to $100 per procedure.
Although relatively inexpensive compared to the overall cost of IVF, it is not always clearly listed or itemized by clinics and patients may combine it with several other add-ons over repeated treatment cycles.
In 2024, it was revealed that an expensive in vitro fertilization technique known as intracytoplasmic sperm injection, widely used in Australia, was being sold unnecessarily to thousands of patients and could even reduce their chances of having a baby.
Last year, Researchers from three universities also warn against widespread use and marketing of IVF add-on services.
Analysis of non-essential services provided to Australian fertility patients University of Melbourne researchersIt found that 44 types of treatments ranging from free to $5000, including ovarian plasma injections, genetic embryo testing and endometrial scraping, had little or no effect on the chances of a live birth, pregnancy or miscarriage.
Australia’s health ministers ordered a rapid investigation The country’s assisted reproduction industry after a series of bungles and scandals.
Wang said researchers now want to apply their approach more broadly to determine which IVF interventions work and those that have minimal or no benefit.
“The bottom line is that any intervention provided to the patient must be supported by reliable evidence,” he said.
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Melissa Cunningham is The Age’s health correspondent. He has previously covered crime and justice issues.Connect with: X or email.
