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Abstract

Study question: What factors are important for patients when evaluating the efficacy, safety, cost and acceptability of IVF add-ons?

Summary answer: Although efficacy is the most important factor for patients, interim markers of success can also be important.

What is known already: IVF add ons are increasingly offered alongside assisted conception despite limited evidence of their efficacy, safety, or value for money. Capturing patient perspectives on their acceptability and outcome priorities is essential to guide ethical clinical practice and inform future research.

Study design, size and duration: Three online focus groups were conducted with 12 people who had used assisted reproductive technologies and were not currently in treatment. The focus groups were conducted in small groups of 3-5 people with each focus group lasting approximately 2 hours.

Participants/materials, setting and methods: Participants were recruited through fertility charities and patient advocacy groups. All 12 participants were women and lived in the United Kingdom. All were currently in a relationship, and most had prior experience of using IVF add-ons. Online focus groups were conducted to discuss views on the efficacy, safety, and acceptability of IVF add ons, and to identify preferred outcomes.

Main results and the role of chance: Nearly all participants defined the most important outcome of using an add-on to be achieving a live birth. However, they recognised that a live birth could feel a distant endpoint within the IVF treatment and therefore valued interim milestones as indicators of success. The main theme found in relation to understanding the risks involved was the need for patients to balance risk with desperation to have a baby. In terms of cost, two themes emerged, the need to balance cost with needing money for future treatments and the differing views on what is an acceptable cost. When receiving information about add-ons, participants reflected on the importance of finding reputable sources whilst also having to navigate conflicting information. Overall, the effectiveness of an add-on was valued over cost and safety, although cost and the risk of regret remained important considerations in decision-making. Most participants would not regret using add-ons, although some said they may regret not having used them.

Limitations, reasons for caution: All participants were women, and most were White. Findings may not be applicable to other populations.

Wider implications of the findings: Capturing participants’ views on efficacy, safety, cost and acceptability is essential not only to guide future research priorities but also to inform ethical clinical practice and policy. By incorporating patient perspectives, future trials can ensure that outcomes reflect what matters most to those undergoing treatment, thereby improving the relevance and impact of research in reproductive medicine.

Publication Type:	Article
Additional Information:	© 2026 Oxford University Press. This is the accepted manuscript of an article published by Oxford University Press. Please refer to the publisher’s terms and conditions for information on re-use.
Publisher Keywords:	IVF Add-ons, patient perspectives, Treatment journey, Ethical decision making, patient centred care
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Department of Psychology & Neuroscience
SWORD Depositor:	Symplectic Administrator

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