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The most important question most patients have about IVF is: What are my chances of getting pregnant?
This is a difficult question to answer, since there are so many variables involved. Chances of success depend upon:
Of course, there are some variables about which nothing can be done, such as the wife's age. But other variables can be controlled to try to maximize chances of a pregnancy! The good news is that with improving IVF technology, pregnancy rates with IVF have increased dramatically.
Pregnancy rates are related directly to how many embryos are transferred. For example, when three good quality embryos are transferred, the chance of pregnancy is about 40% in that cycle. The number of embryos transferred needs also to be balanced against the risk of multiple pregnancies, which naturally increases with more embryos. With this in mind, the Fertility Society of Australia recommends that no more than three embryos be transferred during any treatment cycle. Studies done the world over show that the average pregnancy rate per cycle for IVF is about 30 % for most patients; and about 40% for GIFT.
How can a patient interpret this figure? For example, let us consider a 30-year-old patient with irreparable tubal damage who goes through one IVF cycle. She can look at the pregnancy rate figure of 30 % in two ways. A success rate of 30 % means there is a 70 % chance she will not get pregnant. On the other hand, if she does not go in for any treatment, her chance of getting pregnant is zero. The IVF cycle has increased this to 30 % - no one can do any better than this today! Of course, for the couple that gets a baby, it's a 100% baby - and for the one who fails, it's 0%. For the individual patient, it's really not a question of statistics! Each IVF treatment cycle is a bit like taking a gamble - and you need to hope for the best and prepare for the worst!
IVF treatment should not be considered to be a single shot affair. Patients should plan (mentally at least!) to go through at least three to four cycles to give themselves a fair chance of getting pregnant. With four treatment cycles, the chance of getting pregnant (the cumulative conception rate) is about 70%. What this means is that even though the chance of getting pregnant in a single cycle may never be more than 40%, over a period of four treatment cycles, the chances increase to 70% because the success rate is cumulative. Thus, let us assume the pregnancy rate for IVF at a clinic is 30%. If 10 patients start an IVF cycle, three will get pregnant, leaving seven patients. If these seven do another IVF cycle, another 30% (2.1 patients - so let's say another two) will conceive. If the remaining five do another cycle, one more will get pregnant; and at the end of the fourth cycle, one more will conceive; so that of the 10 patients who started, seven will have got pregnant in four attempts. This is because the chances of getting pregnant in the next IVF cycle do not decrease just because a pregnancy has not occurred in the previous cycle, so the best bet would be to keep on trying. Theoretically, we could reassure every couple taking IVF treatment that they would get pregnant, provided they are willing to go through as many cycles as are required, till they hit the jackpot! Of course, one has to set a limit somewhere, and the decision when to stop is something that only the couple can make for themselves. After more than six failed IVF cycles, the chance for a pregnancy with IVF does decline.
© Dr. Aniruddha Malpani and Dr. Anjali Malpani www.drmalpani.com
Credits: How to Have a Baby: Overcoming Infertility
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