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Predicting Your Chances of Getting Pregnant with IVF: Ovarian Factors
a blog by Mylene Yao, M.D., CEO and Co-Founder, Univfy, Inc., April 29, 2013
You may find yourself at a crossroads in your infertility treatment and wishing for a crystal ball that can show you the future and point you down the right path. Should you try a first or second IVF? How likely are you to get pregnant with your own eggs? Should you consider the option of donor eggs?
Although we haven’t found a crystal ball to answer these questions, we have developed statistical models for predicting your personal probability of pregnancy with IVF, based on our research into thousands of patient IVF cycles in diverse situations. In this three part series, we will look at three types of fertility factors that we have found to predict fertility in our statistical models: ovarian, sperm, and other medical factors.
You probably know that as you get older, you will have more difficulty conceiving, even with IVF. This is because as we age, the supply and the quality of our eggs decline. The challenge in making sense of this decline is that everyone moves down that slope at a different speed. Two women at the same chronological age will not necessarily have the same egg number or egg quality, making age alone an incomplete predictor of fertility. Many other fertility factors also play a role and affect the impact of other factors and so should be considered when predicting your fertility and your personal probability of IVF success.
Your ovarian egg supply, also called your ovarian reserve, is one fertility factor which can be estimated using two blood tests: your FSH level on Day 3 and your AMH level. A low FSH and a high AMH suggest that your ovarian reserve may be good. Your doctor may already use these lab results to determine an appropriate starting dose of ovarian stimulation medications for your IVF cycle. Some doctors also use antral follicle count, an ultrasound measure of the number of small follicles in the ovaries, which is also an estimate of your ovarian reserve.
If you have had IVF before, your previous response to gonadotropin medications is another ovarian fertility factor that is predictive of how well you might do in a subsequent IVF cycle. For instance, an older patient may have a better than expected probability of pregnancy if her ovarian reserve tests and previous ovarian IVF stimulation history indicate that she typically produces the optimal number of mature eggs for IVF, without needing extra-large doses of IVF medications. On the other hand, a younger patient may have a poorer than expected chance of success with IVF if she requires large doses of medication and recovers average or below average number of eggs.
In the next, post we will look at some male factors that can impact your fertility and probability of pregnancy with IVF.