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What Are My Chances Of Success With IVF?

Article sponsored by Univfy, makers of IVF Prediction Tests.

Today, many sources of information are available to help you gauge your probability of success with in vitro fertilization or IVF, which in turn may help you choose how you would like to build your family. 

Many patients think that an excellent IVF success rate is 80% or above, and that anything below 50% is poor. Well, did you know that even a young and fertile couple has just a 15-20% chance to conceive naturally in any one month? Women with top chances of IVF success have per-cycle success rates of 40% or higher, while the majority of women have per-cycle success rates of 20-35%. Having this perspective may help you think about trying more than one cycle, and feel less discouraged if the first one doesn’t work.

The Society for Assisted Reproductive Technology or SART, gathers data from its member clinics on assisted reproductive technologies that include IVF with patients’ own eggs, IVF with donor eggs, intracytoplasmic sperm injection (ICSI), transfer of cryopreserved (e.g. frozen) embryos, and IVF with the use of a gestational carrier.(1-3)

On www.sart.org, when you use “Find a Clinic” under the IVF Success Rates tab and follow the prompts to choose your clinic of interest, you will be brought to a "Clinic Summary Report", where you could choose the type of treatment and diagnosis. Then you will see the percentage of clinical pregnancies, live births, and multiple births shown by age groups, and the number of  cycles per age group. You will naturally focus on the average success rates reported for your age group. However, age-based estimates may be misleading(4), as every woman’s ovaries age at a different pace. Further, the average age-based success rates are a mixed bag of first-IVF cycles, second or third cycles or beyond, and do not distinguish cycles having different clinical diagnoses. The statistics track IVF cycles – not specific patients and their outcomes based on their age and diagnosis.

In reality, your IVF success is affected by many factors in addition to age, such as your height, weight, (body mass index), ovarian reserve tests, sperm count, reproductive history (e.g. the number of pregnancies, miscarriages, etc.), and clinical diagnoses.(4,5)  Entering your fertility health profile into an online prediction tool can provide you with your personalized chance of having a baby with IVF. 

If you have had one or more unsuccessful IVF attempts, you can enter specific information from previous IVF cycles, such as embryo quality, amount of hormonal drugs used, endometrial thickness and infertility diagnosis, to learn your chances of having a baby in the next IVF cycle, which may inform your decisions about treatment paths.

You can take a few easy steps to check whether an online prediction test is sound and right for you. First, make sure the test is based on patients treated in countries including yours. That is, a test based on just UK patients is not meaningful to US patients, because laws governing treatment protocols like embryo transfer are different in the UK. You also want to check that the prediction test is validated, or proven, against a separate group of patients, and that test results prove far more accurate than age-based statistics.(4-6)

Your doctor is your ultimate resource to counsel on medical options that are right for you. He/she applies clinical experience, intuition, and knowledge gained from his/her own clinic’s data when reviewing your comprehensive health history, financial situation, socio-emotional factors, and personalized prediction test results that you may have obtained from other sources. Your doctor will consider all of this information when tailoring the treatment plan for you.   

When you see your doctor, you can ask whether you are like the “average” patient according to the SART data. If not, what factors might make you different from the average patient and how might that affect your chances.  If you have taken an online prediction test, bring the test report to your doctor, as this information is likely to contribute to your discussion, whether your doctor agrees with the predicted success rate or not. If you don’t understand how SART or personalized predictions jive with the estimates provided by your doctor, ask your doctor to explain it so you can decide the best family building options for you.  

References.

1. Assisted reproductive technology in the United States: 2001 results generated from the American Society for Reproductive Medicine/Society for Assisted Reproductive Technology registry. Fertility and sterility. Jun 2007;87(6):1253-1266.
2. Sunderam S, Chang J, Flowers L, et al. Assisted reproductive technology surveillance--United States, 2006. MMWR Surveill Summ. Jun 12 2009;58(5):1-25.
3. Wright VC, Chang J, Jeng G, Macaluso M. Assisted reproductive technology surveillance--United States, 2005. MMWR Surveill Summ. Jun 20 2008;57(5):1-23.
4. Banerjee P, Choi B, Shahine LK, et al. Deep phenotyping to predict live birth outcomes in in vitro fertilization. Proc Natl Acad Sci U S A. Aug 3 2010;107(31):13570-13575.
5. Lannon BM, Choi B, Hacker MR, et al. Predicting personalized multiple birth risks after in vitro fertilization-double embryo transfer. Fertility and sterility. Jul 2012;98(1):69-76.
6. Leushuis E, van der Steeg JW, Steures P, et al. Prediction models in reproductive medicine: a critical appraisal. Hum Reprod Update. Sep-Oct 2009;15(5):537-552.

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