IVF add-ons: you don’t have to say yes to everything to give yourself a chance

Black women TTC can face costly fertility decisions. Learn what IVF add-ons are, what the evidence says and what to ask before paying more.

If you’re a Black woman considering IVF, you may already be holding quite a lot. The appointments. The waiting. Finding space for treatment around work and everyday life. Deciding who to tell, and how much you want to share.

If you’re trying to conceive with a partner, there may also be conversations about money, expectations and how you’re both coping. Then someone mentions an extra test or treatment that might improve your chances. And suddenly there’s another decision to make. If we don’t pay for this, are we missing an opportunity?

I want to make something clear from the start: you do not have to agree to every extra treatment to show how much you want a baby.

You deserve to understand what is being offered, why it is being recommended and whether there is good evidence that it could help you.

What are IVF add-ons?

Add-ons are optional tests or treatments offered alongside fertility treatment. They might involve an additional procedure, a test or a particular laboratory technique. In June 2026, the Human Fertilisation and Embryology Authority (HFEA), the UK’s fertility regulator, highlighted poor or insufficient evidence for many add-ons.

It explained that none of the add-ons it had reviewed had been shown to increase the chance of having a baby for most fertility patients. There can, however, be particular medical circumstances or other treatment goals that justify their use. That distinction matters. Something being offered by a clinic doesn’t, on its own, tell you how useful it will be for you.

When “doing everything” starts to feel like your responsibility

When you want a baby, an optional extra can feel anything but optional. You might worry about regretting your decision later. Perhaps your partner wants to try everything available, while you’re feeling unsure. Or you’ve read someone’s story online and wondered whether the treatment they had could be the missing piece for you.

Those feelings deserve space. They shouldn’t be used to hurry you into spending more money. For Black women, there may be another layer to these conversations. If you’ve previously felt dismissed or unheard in healthcare, questioning a recommendation might feel uncomfortable. You may find yourself wondering how to ask without being labelled difficult.

You are entitled to an explanation that makes sense to you. You can respect a practitioner’s expertise and still ask them to explain their advice. You can ask again if the first answer leaves you confused. Culturally attuned care should make room for your concerns, your experiences and your questions, without making assumptions about you because you’re Black.

My holistic approach includes asking about the evidence

At Auré, our commitment to delivering holistic care includes looking at the whole person: your physical health, emotional wellbeing, relationships, cultural needs and the demands of your everyday life. It also means being thoughtful about what you’re being asked to take on. Another expense. Another appointment. Another procedure. Another thing to pin your hopes on. Before adding something, I want there to be a clear conversation about its purpose. You deserve honesty about what is known, what remains uncertain and what any support is intended to offer.

Six questions to take into your next appointment

You don’t need to become a fertility expert before you can make an informed decision. These questions can help you get a clearer explanation.

1. What are you recommending, and why are you recommending it for me? Ask for an explanation in everyday language. What specific part of your history or treatment makes this worth considering?

2. Is there evidence that it improves my chance of having a baby? A treatment might affect a laboratory result or another stage of the process. Ask whether that translates into a better chance of a live birth.

3. How relevant is the research to my circumstances? Ask about your age, diagnosis and previous treatment. You can also ask whether Black women were represented in the research, and what the available evidence can tell you about your own situation.

4. What are the possible risks and burdens? Include discomfort, side effects, extra appointments and emotional strain in that conversation.

5. What is the full cost? Ask whether it could involve further tests, medication or repeat charges, so you understand the whole commitment.

6. What would my treatment plan look like without it? Ask whether declining it would change the recommended care, and why. The HFEA provides colour-coded ratings explaining the evidence behind individual add-ons.

These distinguish between conflicting findings, insufficient evidence, evidence of no benefit and concerns about safety or reduced effectiveness. Some ratings also relate to particular patient groups or outcomes, so read the explanation alongside the colour. You can ask your clinic to go through the relevant page with you.

If you’re making the decision as a couple

You may want the same outcome and still feel differently about the next step. One of you might feel reassured by doing more. The other might feel exhausted by the thought of another intervention or worried about the cost. Try to make room for both responses. It may help to write your questions together before an appointment and agree what information you need before deciding.

Where treatment timing allows, ask for space to talk afterwards. And where a procedure affects one partner’s body, their comfort and consent must remain central. You can also decide together how much you want to share with family and friends. Loving advice can still become overwhelming. You’re allowed to keep some decisions between yourselves and your care team.

Your wellbeing belongs in the conversation

When I talk about holistic fertility care, I want there to be room for how you’re managing between appointments. Are you getting the emotional support you need? Is treatment taking over every conversation? Do you have somewhere you can speak openly without having to explain or minimise your experience as a Black woman? Those questions matter too.

Looking after yourself might include nourishing meals that fit your tastes and culture, rest where possible, counselling, practical help or time with people who allow you to be yourself.

None of this needs to become another list you must complete perfectly. You don’t need to feel calm or positive all the time to deserve care.

You can want this deeply and still set limits

Being able to afford an add-on doesn’t mean you have to buy it. Having a limited budget doesn’t mean you’re less committed. The HFEA encourages people funding their own treatment to consider whether money spent on unproven extras might be better reserved for further cycles of established treatment.

That is a conversation to have in the context of your circumstances, finances and wishes. My message to Black women and couples navigating IVF is this: let there be room for your questions as well as your hope. Ask for clear information. Ask how the recommendation relates to you. Take time to consider it where you can.

At Auré, that is part of what we mean by holistic care: feeling supported enough to make a decision you understand, with your wellbeing and your voice at the centre.

Disclaimer: This article is for general information and educational purposes only. It does not constitute medical advice, diagnosis or treatment and should not be used as a substitute for advice from a qualified fertility specialist, doctor or other healthcare professional.

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