Medical adjuncts in IVF: evidence for clinical practice.

The cross-talk between the embryo and the endometrium, leading to implantation, is a complex, dynamic and highly controlled phenomenon. Over the last decade, a large amount of translational and clinical research has been carried out in an attempt to increase the likelihood of pregnancy in in vitro fertilisation (IVF). The purpose of this article was to review the literature on the effectiveness of adjuvant therapy in IVF and to provide fertility professionals with evidence-based guidance and recommendations. Clinicians who decide to prescribe therapies for which the evidence base is weak, should make patients aware of this lack of knowledge and potential adverse effects. There is a need for good clinical trials in many of the areas surrounding medical adjuncts in IVF to resolve the empirical/evidence divide.