IVF Add-Ons: Which Ones Are Worth Paying For?

The HFEA traffic-light system

The HFEA — the UK's fertility regulator — rates add-on treatments using a traffic-light system. Green means there's good evidence it works for at least some patients. Amber means the evidence is conflicting or limited. Red means there's no good evidence it improves birth rates. As of early 2026, not a single add-on treatment has a green rating across the board.

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.

PGT-A (preimplantation genetic testing)

Cost: £2,000–£3,500. HFEA rating: amber. 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 evidence is mixed. Several large trials have shown no improvement in live birth rates per cycle started, partly because the biopsy process can damage embryos and the test isn't 100% accurate.

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: amber. 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. The technology is genuinely useful for selection — but whether it improves birth rates over standard assessment is unproven. 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: red. 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. Despite this, some clinics still offer it. The evidence says save your money.

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.

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.

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.