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Keep Trying? Success of Cumulative IVF May Approach Natural Birth Rate

by Leigh Ann Woodruff, June 28, 2012

It may get expensive, but there is good news for women undergoing in vitro fertilization (IVF). A new study published in the New England Journal of Medicine has found that women who undergo multiple fertility treatments may be nearly as likely to deliver a baby as women who conceive naturally. The average cost of an IVF cycle is around 12,400.

“Having the data to demonstrate that medically assisted conception can nearly match rates of natural conception is an important milestone,” says Dolores J. Lamb, PhD, President of the American Society for Reproductive Medicine.

The Michigan State University study of nearly 250,000 U.S. women sought to estimate cumulative success rates for IVF with continued treatment. Traditionally, assisted reproductive technology (ART) success is reported through the Centers for Disease Control and Prevention's (CDC) Assisted Reproductive Technology Report, and live birth rates are reported per cycle (per one course of treatment).

The researchers obtained data from the Society for Assisted Reproductive Technology’s (SART) Clinic Outcome Reporting System for women undergoing fertility treatment between 2004 and 2009. The system contains data on more than 90 percent of all clinics performing ART treatments in the United States.

They found that in looking at 246,740 women, 57 percent of women achieved a live birth via assisted reproductive technology, and 30 percent of all ART cycles resulted in a live birth. Success rates declined with increasing age for women using their own eggs, especially for those ages 38 years and older, but not for women using donor eggs.

“This study provides patients with important and encouraging information” says Glenn Schattman, M.D., president of the Society for Assisted Reproductive Technology. “While tracking outcomes by cycle started or single embryo transfer is a valuable method for assessing quality, having cumulative data linked to individual patients better estimates the prospect for success when they start a treatment cycle. SART and its member clinics have invested enormous time and resources into tracking outcomes data for decades, all with the goal of improving patient treatment."

The estimated natural fertility rate of the general population is about 20 percent per month. The estimated rate of conceiving spontaneously after three months is 45 percent, after six months it's 65 percent, and after 12 months, it's 85 percent.

The study found that the two major factors that influence ART success are age and good embryo quality. Among older women, live birth rates can be substantially improved with continued treatment and switching to donor eggs, which is, of course, a very personal decision for women. They found that for women under age 31 undergoing ART, the live birth rate is 42 percent for the first cycle; 57 to 62 percent for a second cycle; 63 to 75 percent by a third cycle and 66 to 83 percent in the fourth cycle. Among women 43 and over, the chances of success with their own eggs are about 4 percent for the first cycle; 6 to 8 percent for the second; 7 to 11 percent for the third; and 7 to 15 percent for a fourth cycle.

The study demonstrates that when using a woman’s own eggs, the success rates continue to rise beyond two to three cycles. In addition, it may help providers and women decide when it is appropriate to change to donor eggs.


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