Of course, there is also the compromise approach to getting a good fit & seal, without going full-custom shell, and that is to get custom ear-tips:
http://www.acscustom.com/us/index.php/in-ear-monitors/custom-earphone-sleeves
https://www.earplugstore.com/cusfitearmol1.html
https://www.digitaltrends.com/home-theater/soundmolds-headphone-eartips-review/
https://www.macworld.com/article/1155617/etymotic_custom_fit.html
Never tried them, myself.
I'm a full-custom-shell (CIEM) fan (and I admit there can be a
lot of hassle with getting CIEMs to fit accurately, which is why
this thread came into being).
In the same way that different shapes and materials of universal tips may subtly alter the sound character of a universal-shell IEM, it is possible that custom-moulded silicone ear tips may do so, too, so that's another variable one shouldn't overlook (for example, you can see that, in recent years, companies like FitEar have been using metallic tubing in their CIEMs, specifically because they recognise that it influences the subjective sound character of their products. Other companies, like SpiralEar, very deliberately choose to make their sound tubes from silicone, rather than the more conventional plastic ones, so common in the CIEM industry - this is
not because SE's shells happen to be silicone).
So many variables to consider, on the universal-shell side of the industry that you are a customer of - to tell you the truth, I feel quite sorry for universal-shell IEM makers, because all these variables can (potentially) undermine their intended tunings on their various products. Then again, even CIEM products aren't immune to such variation, because, in addition to every human being perceiving things slightly differently, there's also the fact that each pair of CIEMs will have a slightly different distance between output nozzle and eardrum, and different volumetric proportions of the ear canal, all of which may alter the sound, even before the idiosyncrasies of each human brain are involved!
However, if one feels like going the custom-tip route, to improve consistency of fit and seal with their universal-shell IEMs, they should also pause and consider if different IEMs may have different nozzles lengths / different depths of insertion. IF they are unlucky, they
might need to get different custom tips for each IEM they own, but it may still be worth it, as custom tips are (thankfully) not insanely expensive. Then again, one might be lucky and be able to use one set of custom tips on several IEMs.
None of the above is intended to be negative. Really, not at all. In many cases, custom tips are a viable option and may increase isolation, fit, seal, comfort, and listening pleasure significantly, but it's just that it pays to take that path with the knowledge of some of the variables that may influence the final outcome!