Abstract
Advancements in assisted reproductive technologies (ARTs) have led to the development of various add-on techniques aimed at improving oocyte quality and enhancing embryo implantation potential. These techniques target critical stages of both oocyte and embryo physiology, including oocyte growth and maturation, fertilization, chromosomal status, and embryo development. Key approaches involve the optimization of in vitro fertilization (IVF) protocols, recruiting capable follicles giving rise to dynamic oocytes to evolve, culture media supplementation, preimplantation genetic testing (PGT), and mitochondrial replacement therapy (MRT), all of which are designed to enhance oocyte competence through its function and metabolism. The use of PGT has been promising in selecting embryos suitable for transfer, thus optimizing implantation success. Emerging technologies, such as platelet-rich plasma treatment (PRP), time-lapse imaging (TLI), and hyaluronan-rich (HA) culture media, claim to improve ovarian rejuvenation and uterine receptivity, embryo selection, as well as embryo implantation potential, respectively. Evidence for certain add-on approaches remains limited, but ongoing research suggests that the use of such treatments may lead to increased clinical pregnancies and live birth rates, especially in poor-prognosis patients. The present review describes the current state of the add-on innovations, their mechanisms of action, as well as their possibilities to increase ART success rates.