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The September ESHRE Journal Club discussed a paper from Lensen et al.(2021) about the prevalence and pattern of add-on use in ART. The paper was based on an online national survey in Australia for women having ART treatment over a 3-year period. Survey questions covered demographics, IVF history and the use of IVF add-ons. This survey showed that 82% of the 1590 eligible patients have used at least one add-on during treatment and usually at an additional cost (72% of cases). The majority of patients shared the decision of add-on use with their fertility specialist and placed a high level of importance on safety and efficacy based on scientific evidence. The study also highlighted a high proportion of patient regret (83%) after unsuccessful treatments and when the specialist had a larger contribution in the decision to use add-ons (75%). Due to large add-on utilization, it was interesting for Journal Club …