Add-ons in der Reproduktionsmedizin

The success of our current fertility treatment using in vitro fertilization (IVF) is still measured by the pregnancy rates achieved but optimally by the birth of a child. These rates have been documented by the German IVF Registry with respect to the homologous IVF/intracytoplasmic sperm injection (ICSI) treatment since 1991 and showed steadily rising rates to the present day from originally 20% to 32% (in all age groups). This could be achieved mainly due to enormous technical advances; however, in recent years only very small steps seem to be possible in Germany as well as internationally. The search for so-called add-ons, which could extend the conventional approach to hormonal stimulation, embryo culture, transfer and implantation and could lead to an improvement in success rates, is therefore becoming increasingly more intensive. Various additional measures are used in patients in the context of artificial insemination which appear to have scientific rationale and may bring benefits but which could not yet be scientifically proven. Further studies are therefore necessary to identify those add-ons that make a meaningful contribution in this difficult conflict situation. The following article provides an overview of the relevant current additional measures in the IVF/ICSI treatment and is intended to encourage critical evaluation.