New Advances in IVF Treatments: Do They Work?

I often get asked whether all these new advances in IVF really make a difference, or whether they are just “add-ons” that sound good on paper. The honest answer is somewhere in between, and that’s usually where real medicine lives anyway.

IVF outcomes today are certainly better than they were 10 or 15 years ago. Laboratory conditions are more refined, embryo culture systems are smarter, and our understanding of timing, stimulation, and embryo selection has improved. That said, there is still one factor that outweighs almost everything else, and that is the woman’s egg reserve and, even more importantly, the genetic quality of those eggs. No technology, no matter how advanced, can fully override the biology of oocyte aging. This is something I always try to explain early, even if it’s not what patients are hoping to hear.

In younger women, IVF success rates are largely driven by the fact that most oocytes are genetically competent. As female age advances, especially after the late 30s, the proportion of chromosomally normal eggs drops quite significantly. This is why, after a certain age, there is unfortunately no single treatment that comes close to the success rates of IVF with donor eggs. That reality does not disappear no matter how advanced our tools become, and it’s important to keep this in mind when setting expectations.

However, this does not mean that we are powerless. There are several strategies that can genuinely help us maximize the chances of success by working with the biology we have, rather than fighting against it.

One such strategy is oocyte or embryo banking. The concept is actually quite simple. Instead of relying on a single stimulation cycle and the limited number of eggs retrieved from that cycle, we perform two or sometimes three IVF cycles back-to-back, freezing the eggs or embryos from each cycle. When you look at it from a statistical point of view, this makes a lot of sense. If one cycle yields, for example, four or five mature oocytes, banking across multiple cycles can double or even triple the total number of oocytes or embryos available. Since each egg carries an independent chance of being genetically normal, increasing the pool directly improves the likelihood of ending up with at least one healthy, transferable embryo (Vaiarelli et al., 2020). It’s not magic, but it is probability working in your favor.

Another area that has gained a lot of attention is ovarian PRP and exosome applications. These approaches aim to improve the ovarian microenvironment and support primordial follicle recruitment. The goal here is not to create new eggs, which is biologically unrealistic, but to help the ovary function in a more supportive and less inflammatory state. By improving local signaling, blood flow, and cellular communication, we may be able to enhance the responsiveness of the ovary to stimulation and, in some cases, the quality of the oocytes retrieved (Sfakianoudis et al., 2019; Pantos et al., 2022). It doesn’t work the same way for everyone, and results vary, but in selected patients it can be a useful tool.

Cytoplasmic transfer is another technique that can help in very specific situations. Here, the idea is to support the oocyte’s internal machinery. As eggs age, mitochondrial function declines, and this affects energy production, fertilization dynamics, and early embryo development. By supplementing the oocyte cytoplasm with healthier cytoplasmic components, we aim to improve oocyte competence and support the high energy demands of fertilization and early cell division (Dale et al., 2017). Again, this is not a universal solution, but in carefully selected cases it can tip the balance slightly in our favor.

Finally, none of these approaches work in isolation from the basics. I strongly believe in the importance of lifestyle and metabolic health. A Mediterranean-style diet, mild to moderate regular exercise, and targeted supplementation can all contribute to a lower inflammatory state and improved oxidative balance. Nutrients such as omega-3 fatty acids, certain antioxidants, and adequate levels of vitamins and minerals play a role in cellular function and mitochondrial health. These changes won’t reverse age, but they can help optimize the parameters we are able to influence (Gaskins et al., 2019; Silvestris et al., 2021).

So where does this leave us? Modern IVF technologies absolutely matter, and they can improve outcomes when used thoughtfully and in the right context. But they work best when expectations are realistic and biology is respected. In advanced age brackets, we can introduce strategies that improve odds and make cycles more efficient, yet there remains a point where donor eggs offer a level of success that no other option can match. The key is understanding where you are on that spectrum and choosing the path that aligns best with both science and personal goals.

References

Dale, B., Elder, K. & Cohen, J. (2017) Cytoplasmic transfer in assisted reproduction: reappraisal of the evidence. Reproductive Biomedicine Online, 34(1), 13–18.

Gaskins, A.J. et al. (2019) Dietary patterns and outcomes of assisted reproduction. Human Reproduction, 34(2), 294–302.

Pantos, K. et al. (2022) Ovarian rejuvenation using platelet-rich plasma and related biologics. Journal of Assisted Reproduction and Genetics, 39(4), 829–839.

Sfakianoudis, K. et al. (2019) Autologous platelet-rich plasma treatment enables pregnancy for women in advanced reproductive age. Journal of Clinical Medicine, 8(1), 1–15.

Vaiarelli, A. et al. (2020) Oocyte and embryo accumulation strategies in poor prognosis patients. Current Opinion in Obstetrics and Gynecology, 32(3), 175–182.

Silvestris, E. et al. (2021) Nutrition and female fertility: oxidative stress and inflammation as common mediators. Reproductive Biology and Endocrinology, 19(1), 1–12.