IVF Add-Ons: Which Ones Are Worth Paying For?
After agreeing to a base IVF cycle, many patients are offered a list of additional procedures: endometrial scratching, time-lapse imaging, PGT-A genetic testing, embryo glue, intralipid infusions. Each comes with its own price tag — typically £100 to £3,500 — and its own set of claims about improving your chances. The total can easily add 50–100% to your bill. The question is whether any of it is backed by evidence.
In this article
- 1.The HFEA traffic-light system
- 2.How much do IVF add-ons cost?
- 3.PGT-A (preimplantation genetic testing)
- 4.Time-lapse imaging (EmbryoScope)
- 5.Endometrial scratching
- 6.Embryo glue (hyaluronan)
- 7.Intralipid infusions and immune treatments
- 8.The total add-on bill: a real example
- 9.How to navigate the conversation with your clinic
The HFEA traffic-light system
The HFEA — the UK's fertility regulator — rates add-on treatments using a five-category system. Green means there's good evidence it works. Amber means the evidence is conflicting. Grey means there isn't enough evidence to rate it. Black means evidence shows no effect on outcomes. Red means no effect or potential safety concerns. As of early 2026, PGT-A has a green rating specifically for reducing miscarriage risk, but no add-on has a universal green rating for improving live birth rates.
That doesn't mean they're all useless. It means the evidence isn't strong enough to recommend them routinely. For some patients in specific circumstances, certain add-ons may help. The problem is that clinics often present them as standard upgrades rather than targeted interventions.
How much do IVF add-ons cost?
Here's a breakdown of the most commonly offered add-ons, their typical costs, and the HFEA's evidence rating:
| Add-on | Typical cost | HFEA rating | Evidence summary |
|---|---|---|---|
| PGT-A genetic testing | £2,000–£3,500 | Red (birth) / Green (miscarriage) | May reduce embryos available; green-rated for lowering miscarriage risk |
| Time-lapse imaging (EmbryoScope) | £500–£800 | Black (no effect) | Evidence shows no effect on birth rates |
| Endometrial scratching | £150–£400 | Amber | Conflicting evidence — large trial found no benefit |
| Embryo glue (hyaluronan) | £100–£350 | Amber | Some evidence of modest implantation improvement |
| Intralipid infusions | £300–£1,000 per infusion | Red | Not supported by robust evidence |
| Immune testing (NK cells) | £350–£1,000 | Red | Blood NK levels don't predict uterine behaviour |
| Assisted hatching | £300–£600 | Grey (insufficient evidence) | Not enough evidence to rate |
| IMSI (high-magnification sperm selection) | £200–£500 | Amber | Limited evidence of benefit over standard ICSI |
If a clinic recommends several of these — which is common — the total easily reaches £3,000–£5,000 on top of your cycle price. That's a significant amount of money for treatments with unproven benefits.
PGT-A (preimplantation genetic testing)
Cost: £2,000–£3,500. HFEA rating: red for improving live birth rates, green for reducing miscarriage risk. PGT-A screens embryos for chromosomal abnormalities before transfer. The theory is sound — transferring a chromosomally normal embryo should reduce miscarriage risk and improve implantation. In practice, the HFEA rates it red for birth rates because it often reduces the number of embryos available for transfer and may lengthen time to conception. However, it does have a green rating for lowering miscarriage risk. Several large trials have shown no improvement in live birth rates per cycle started.
Where it may help: patients over 37 with multiple embryos, where selecting the most viable one matters. Where it probably doesn't help: younger patients with few embryos, where you'd transfer them all anyway.
Time-lapse imaging (EmbryoScope)
Cost: £500–£800. HFEA rating: black (no effect on outcomes). Time-lapse incubators take continuous photos of developing embryos without removing them from the incubator. This gives embryologists more data to select the best embryo. However, the HFEA has rated this black — meaning moderate/high quality evidence shows it has no effect on birth rates, whether using automated AI analysis or manual embryologist assessment. Most clinics now use it as standard anyway, so check whether you're being charged extra for something that's already part of their process.
Endometrial scratching
Cost: £150–£400. HFEA rating: amber (conflicting evidence). The idea was that scratching the uterine lining before embryo transfer triggers a healing response that improves implantation. Early small studies looked promising. Then a large, well-designed trial — the endometrial scratch trial published in the New England Journal of Medicine — found no benefit. The HFEA rates it amber because of this conflicting evidence, but the weight of the best evidence suggests little to no benefit for most patients.
Embryo glue (hyaluronan)
Cost: £100–£350. HFEA rating: amber. Embryo glue is a hyaluronan-enriched medium used during embryo transfer. Some studies suggest a modest improvement in implantation rates. At the lower end of the price range, this is one of the more defensible add-ons — the cost is relatively low and the potential benefit, while not proven, is biologically plausible.
Intralipid infusions and immune treatments
Cost: £300–£1,000 per infusion. HFEA rating: red. The theory that 'natural killer cells' in the uterus attack embryos has gained traction online but isn't supported by robust evidence. Blood NK cell levels don't reliably predict uterine NK cell behaviour, and suppressing the immune system during pregnancy carries its own risks. The HFEA and the Royal College of Obstetricians and Gynaecologists both advise against routine immune testing and treatment in the context of IVF.
The total add-on bill: a real example
Consider a typical scenario: your clinic quotes £4,500 for an IVF cycle. They then recommend PGT-A (£2,500), time-lapse imaging (£650), embryo glue (£200), and endometrial scratching (£300). That's an additional £3,650 — bringing your total to £8,150, almost double the original quote. Of those four add-ons, one has evidence of no effect (time-lapse, rated black), one is rated red for birth rates (PGT-A), one has conflicting evidence (endometrial scratching, rated amber), and one has modest support (embryo glue, rated amber).
This is why it's critical to understand what you're being offered before your first consultation. Walking in informed gives you the confidence to ask the right questions.
How to navigate the conversation with your clinic
Ask three questions about any recommended add-on. First: what does the HFEA say about the evidence? Second: is this recommended for my specific situation, or offered to everyone? Third: what's the additional cost, and will you put it in writing before I decide? A good clinic will answer all three without pressure. If you feel rushed or upsold, that's useful information about the clinic.
Related reading on Vero Fertility
On Vero Fertility, we flag which add-ons each clinic offers and their HFEA evidence ratings, so you can see the full cost picture before your first consultation — not after.
Vero Fertility
Data sourced from the HFEA and verified clinic pricing.