What are Adjuvant Therapies?

Adjuvant therapies are defined as therapies undertaken in addition to recognised standard assisted reproductive technology (ART) treatments. These treatment options are may improve the chance of conception and can be medical treatments for the patients or extra measures taken in the laboratory while embryos are being cultured.

Adjuvant Therapies: Medical Treatments

Endometrial Scratching

A minor procedure performed under twilight sedation in theatre, this procedure is intended to improve the lining of the uterus (endometrium) in preparation to receive an embryo. It is performed by causing a small injury (scratch) to the endometrium prior to embryo transfer.

Scientific studies for this treatment have been conflicting and have recently shown to be of no benefit.

Neupogen (Filgrastim)

This treatment involves a wash being applied to the endometrium prior to an embryo transfer to improve the chances of embryo implantation.

While some scientific studies showcase a significant increase in implantation and pregnancy rates, other studies do not.

Endometrial Receptivity Assay (ERA)

The ERA measures the level of hormones in the endometrium to help determine the most suitable time for embryo transfer. It is suggested that in some women, the time that the embryo would most likely implant may be earlier or later than conventional methods propose.

It is proposed that the ERA might identify these individual changes and be of great help in situations where multiple embryo transfer procedures with good quality embryos have not been successful.

While the initial research is promising, larger studies are needed before the benefits of ERA is proven.

Co-Enzyme Q10

Also known as CoQ10, this is a supplement that’s used to improve egg quality. The supplement is important for energy metabolism and prevents oxygen damage.

Studies have demonstrated improved results in regard to eggs collected, embryo quality and fertilization rates for previous poor responding patients, however, pregnancy and live birth rate improvements have yet to be proven.


DHEA is a natural hormone produced by the body and assists with producing sex hormones that are vital for fertility. Levels of this hormone may decline as a person ages, making it increasingly difficult to conceive.

In this treatment, a supplement is prescribed for three months prior to and throughout treatment to improve hormone levels within the body and reinstate its functions.

For this treatment, studies are promising with several demonstrating an improvement in IVF outcomes.

Growth Hormone (GH)

In this treatment, a supplement which controls the possible negative effect of Follicle Stimulating Hormone (FSH) on certain egg cells (which is important for their development and maturation), is injected into the body.

Recent studies have demonstrated no benefit to pregnancy rates for poor responding patients but do show a potential benefit for poor embryo development and poor endometrial growth.

Ultrasound Guided Embryo Transfer

The embryo transfer is a vital part of the IVF process. The embryo transfer may be performed with the ‘clinical touch’ technique or via transabdominal or transvaginal ultrasound.

While transferring under ultrasound guidance has the benefit of visualizing where the catheter is inserted and placing embryos at a desired location in the endometrial cavity, there are some downsides to this method. Not only is the procedure time longer, but two specialists also need to be involved in this treatment. Patients also experience a higher level of discomfort as a full bladder is required.

Adjuvant Therapies: Laboratory Treatments

Time Lapse Imaging

This is an advanced embryo incubation system that does not require embryos to be taken out for visual assessment. This treatment is believed to improve the selection of the embryo with the highest implantation probability.

Current studies do not show an improvement in pregnancy and birth rates with this treatment.

Assisted Hatching

This is a procedure that involves the use of a laser pulse to create a small hole in the outer wall (zona) of a day 3 embryo. This is thought to help the embryo hatch out of the zona in order to implant in the endometrium.

Current studies do not show a benefit to pregnancy and implantation rates with this procedure.

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