Add-Ons for In Vitro Fertilization (IVF)

In vitro fertilization is a proven, effective treatment. For most patients, it achieves the desired outcome without the need for additional procedures. So-called “add-ons” are optional supplementary treatments or tests that are offered as complementary services. Many of these are expensive and lack sufficient evidence. We’ve divided the common add-ons—including those you might be offered elsewhere—into three transparent categories and will tell you openly which ones we use and why.
 

Level 1 – Evidence-Based: What We Specifically Use

1. PGT-A – Chromosomal Analysis of Embryos

With PGT-A, we check before transfer whether an embryo has the normal number of chromosomes. It is a selection process—it does not create healthy embryos, but rather identifies those with a chance of resulting in a live birth. PGT-A has been permitted in Switzerland since 2017, unlike in countries such as Germany or France.
 

Two points are well established: PGT-A reduces the risk of miscarriage, and for women aged 35 and older, the evidence increasingly shows that it also improves the chance of a live birth—because the proportion of eggs with chromosomal abnormalities increases with age. PGT-A offers no benefit for younger women, which is why we do not routinely use it for women under 35. For patients over 35, PGT-A can also prevent unsuccessful transfers and shorten the time to pregnancy. We will discuss with you individually whether PGT-A is appropriate for your situation.

2. Freeze-all – Postponing Embryo Transfer

In certain situations—such as when there is a risk of hyperstimulation or when hormone levels at the end of stimulation make a fresh transfer seem inadvisable—we freeze all embryos and transfer them during a later, more natural cycle. This approach is well-established for these medical reasons. However, it is not a general “booster”; for most patients, a fresh transfer is just as effective, which is why we do not apply the “freeze-all” approach across the board.

3. ICSI – for reduced sperm quality

In cases of reduced sperm quality, the direct injection of a single sperm into the egg (ICSI) has been proven to be beneficial or even essential. Thanks to ICSI, our experienced team of biologists achieves the highest fertilization rates in Switzerland, which is why we use it almost routinely. However, we make a point of not charging an additional fee for ICSI. In the specific Swiss context, where couples pay for the treatment themselves, nearly all Swiss IVF teams consider the generous use of ICSI to be sensible (Swiss average: 84%), as it avoids the risk of complete failure to fertilize following standard IVF, which is still 5–10%.
 

Level 2 – Insufficient evidence; we do not offer these

For these procedures, the evidence is contradictory, weak, or lacking.

• EmbryoGlue (hyaluronic acid-containing medium used during embryo transfer) – Evidence of moderate quality shows a small benefit in terms of live births for fresh transfers, but not for transfers of thawed (frozen) embryos (which are much more common in our practice). We are awaiting further data.
• Endometrial “scratching”—large studies show no benefit
• Time-lapse incubators – do not improve the chance of live birth
• IMSI
• Intralipid infusions
• DHEA/androgen administration
• Sperm DNA fragmentation test
• pICSI – Data Show No Benefit

We use artificial egg activation only when there is a clear indication (e.g., following a previous failed fertilization attempt).
 

Level 3 – Not recommended; we do not offer these procedures

For these procedures, the evidence shows no benefit and, in some cases, potential risks or safety concerns.

• Endometrial Receptivity Test (ERA)—Studies show no benefit, potential harm
• Intravenous immunoglobulins (IVIG)
• Corticosteroids, except in selected patients
• Platelet-rich plasma (PRP)