{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:49:27Z","timestamp":1791996567420,"version":"4.4.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":43,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>IVF add-ons are optional tests, treatments or procedures offered in addition to standard IVF, often at additional cost and with uncertain evidence of benefit. In a commercialized fertility sector, patients must make complex reproductive decisions while navigating variable clinical information, online advice and peer-to-peer narratives. This study examined Reddit as a digital health environment shaping access to information and decision-making about IVF add-ons. Posts and comments from the r\/IVF subreddit were extracted from 14 October to 13 November 2024, filtered using IVF add-on keywords, and manually reviewed for eligibility. Eligible content included anecdotes, claims about benefit or lack of benefit, and\/or recommendations to use or avoid an add-on. Accuracy of claims was independently assessed by two researchers against evidence-based sources, including Cochrane reviews. Of 32 420 posts and comments screened, 1498 were eligible, comprising 2011 relevant statements: anecdotes (n = 1414), claims (n = 250), and recommendations (n = 347). The most frequently mentioned add-ons were preimplantation genetic testing for aneuploidy, aspirin, antioxidants, acupuncture, and growth hormone. Anecdotes more commonly described success than failure (64% vs 36%). Most claims asserted benefit (161\/250, 64%), and most benefit claims were unsupported or contradicted by robust evidence (111\/161, 69%). Recommendations overwhelmingly encouraged add-on use (280\/347, 81%), despite limited supporting evidence. Online forums can provide valuable peer support, but may also amplify unsubstantiated benefit claims and commercially aligned treatment norms. Accessible, independent, evidence-based digital resources are needed to strengthen reproductive autonomy and informed decision-making in women\u2019s reproductive health.<\/jats:p>","DOI":"10.1093\/heapro\/daag151","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T11:22:53Z","timestamp":1791804173000},"source":"Crossref","is-referenced-by-count":0,"title":["Dr Reddit? The quality and accuracy of information about IVF add-ons on Reddit"],"prefix":"10.1093","volume":"41","author":[{"given":"Sara","family":"Attinger","sequence":"first","affiliation":[{"name":"Obstetrics, Gynaecology and Newborn Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne , Melbourne, Level 7 Royal Women\u2032s Hospital, Victoria 3052 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joscelyn","family":"Gan","sequence":"additional","affiliation":[{"name":"Melbourne Medical School, University of Melbourne , Grattan Street, Parkville, Victoria 3010, Melbourne ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amandi","family":"Perera","sequence":"additional","affiliation":[{"name":"Obstetrics, Gynaecology and Newborn Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne , Melbourne, Level 7 Royal Women\u2032s Hospital, Victoria 3052 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikka","family":"Milani","sequence":"additional","affiliation":[{"name":"St Vincent's Hospital Melbourne , Melbourne ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Doyle","sequence":"additional","affiliation":[{"name":"Melbourne Data Analytics Platform, School of Computing and Information Systems, Faculty of Engineering and Information Technology, University of Melbourne , Level 8, Melbourne Connect, 700 Swanston Street, Carlton, Victoria 3053, Melbourne ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Steeper","sequence":"additional","affiliation":[{"name":"Obstetrics, Gynaecology and Newborn Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne , Melbourne, Level 7 Royal Women\u2032s Hospital, Victoria 3052 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3513-4677","authenticated-orcid":false,"given":"Jack","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"Centre for Biostatistics, Manchester Academic Health Science Centre, Division of Population Health, Health Services Research and Primary Care, University of Manchester , Jean McFarlane Building, Oxford Road, Manchester M13 9PL, Manchester ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ektoras X","family":"Georgiou","sequence":"additional","affiliation":[{"name":"Obstetrics, Gynaecology and Newborn Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne , Melbourne, Level 7 Royal Women\u2032s Hospital, Victoria 3052 ,","place":["Australia"]},{"name":"Melbourne IVF , 36 Wellington Street, Collingwood, Victoria 3066 ,","place":["Australia"]},{"name":"Royal Women\u2019s Hospital Reproductive Services, , Level 7, Parkville, Victoria 3052 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tammy","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"Institute for Evidence-Based Healthcare, Bond University , Building 5, Level 4, 14 University Drive, Robina, Queensland 4226, Gold Coast ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1694-1142","authenticated-orcid":false,"given":"Sarah","family":"Lensen","sequence":"additional","affiliation":[{"name":"Obstetrics, Gynaecology and Newborn Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne , Melbourne, Level 7 Royal Women\u2032s Hospital, Victoria 3052 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"2026101412215734300_daag151-B1","author":"Afroz"},{"key":"2026101412215734300_daag151-B2","doi-asserted-by":"publisher","first-page":"994","DOI":"10.1016\/j.fertnstert.2019.10.031","article-title":"Add-ons in the laboratory: hopeful, but not always helpful","volume":"112","author":"Armstrong","year":"2019","journal-title":"Fertil Steril"},{"key":"2026101412215734300_daag151-B3","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-069146","article-title":"Patient and professional perspectives about using in vitro fertilisation add-ons in the UK and Australia: a qualitative study","volume":"13","author":"Armstrong","year":"2023","journal-title":"BMJ Open"},{"key":"2026101412215734300_daag151-B4","doi-asserted-by":"publisher","first-page":"2895","DOI":"10.1007\/s10815-025-03538-x","article-title":"Lost in translation: are doctors really answering patients\u2019 questions about in vitro fertilization?","volume":"42","author":"Daram","year":"2025","journal-title":"J Assist Reprod Genet"},{"key":"2026101412215734300_daag151-B5","author":"eSafety Commissioner","year":"2026"},{"key":"2026101412215734300_daag151-B6","author":"HFEA","year":"2025"},{"key":"2026101412215734300_daag151-B7","author":"Human Fertilisation and Embryology Authority","year":"2022"},{"key":"2026101412215734300_daag151-B8","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/daad059","article-title":"Addressing the digital determinants of health: health promotion must lead the charge","volume":"38","author":"Kickbusch","year":"2023","journal-title":"Health Promot Int"},{"key":"2026101412215734300_daag151-B9","doi-asserted-by":"publisher","DOI":"10.1530\/RAF-22-0136","article-title":"It all depends on why it\u2019s red\u201d: qualitative interviews exploring patient and professional views of a traffic light system for IVF add-ons","volume":"1","author":"Lensen","year":"2023","journal-title":"Reprod Fertil"},{"key":"2026101412215734300_daag151-B10","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1016\/j.fertnstert.2025.05.152","article-title":"From innovation to practice: evaluating the evidence for preimplantation genetic testing for aneuploidy","volume":"124","author":"Lensen","year":"2025","journal-title":"Fertil Steril"},{"key":"2026101412215734300_daag151-B11","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1111\/ajo.13321","article-title":"IVF add-ons in Australia and New Zealand: a systematic assessment of IVF clinic websites","volume":"61","author":"Lensen","year":"2021","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"2026101412215734300_daag151-B12","doi-asserted-by":"publisher","first-page":"1854","DOI":"10.1093\/humrep\/deab098","article-title":"How common is add-on use and how do patients decide whether to use them? A national survey of IVF patients","volume":"36","author":"Lensen","year":"2021","journal-title":"Hum Reprod"},{"key":"2026101412215734300_daag151-B13","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1016\/j.fertnstert.2019.10.011","article-title":"In vitro fertilization add-ons for the endometrium: it doesn't add-up","volume":"112","author":"Lensen","year":"2019","journal-title":"Fertil Steril"},{"key":"2026101412215734300_daag151-B14","author":"Lensen"},{"key":"2026101412215734300_daag151-B15","author":"Lundin","year":"2022"},{"key":"2026101412215734300_daag151-B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2021.114317","article-title":"The crafting of hope: contextualising add-ons in the treatment trajectories of IVF patients","volume":"287","author":"Perrotta","year":"2021","journal-title":"Soc Sci Med"},{"key":"2026101412215734300_daag151-B17","author":"Reddit","year":"2024"},{"key":"2026101412215734300_daag151-B18","author":"Reddit","year":"2024"},{"key":"2026101412215734300_daag151-B19","doi-asserted-by":"publisher","DOI":"10.2196\/17187","article-title":"Prevalence of health misinformation on social media: systematic review","volume":"23","author":"Suarez-Lledo","year":"2021","journal-title":"J Med Internet Res"},{"key":"2026101412215734300_daag151-B20","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1002\/hast.1513","article-title":"Hope and exploitation in commercial provision of assisted reproductive technologies","volume":"53","author":"Wrigley","year":"2023","journal-title":"Hastings Cent Rep"}],"container-title":["Health Promotion International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/heapro\/article-pdf\/41\/5\/daag151\/71947847\/daag151.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/heapro\/article-pdf\/41\/5\/daag151\/71947847\/daag151.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:22:07Z","timestamp":1791994927000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/heapro\/article\/doi\/10.1093\/heapro\/daag151\/8916561"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":20,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/heapro\/daag151","relation":{},"ISSN":["0957-4824","1460-2245"],"issn-type":[{"value":"0957-4824","type":"print"},{"value":"1460-2245","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,10]]},"published":{"date-parts":[[2026,9,1]]},"article-number":"daag151"}}