The latest review of the pregnancy rate achieved through advanced reproductive techniques (ART) like in vitro fertilization (IVF) is the most encouraging ever. One press release read “Success of Fertility Treatment May Approach Natural Birth Rate.” Considering that many couples that need IVF have no other treatment options; this is an extremely encouraging revelation. Since the first successful IVF pregnancy was achieved in 1977 (resulting in the birth of Louise Brown in July 1978); it is estimated that 5 million babies have been born through this technology[r1] ! With the success rate and the need for treatment increasing, it is important that we consider what else we can do meet the needs of even more couples.
Here is what we now know. Even the most fertile couples have a natural fertility rate of about 20% for any given month. Their ultimate success is achieved through repetition; if not successful one month they can try next month, and the month after that until they are successful. Observation shows that they typically achieve a pregnancy rate of 65% within 6 months and 80% within a year. By contrast, couples that need fertility treatment have to pay for each cycle that they are attempting to conceive which often limits their effort to one or two attempts. New data shows that with persistence, infertile couples can achieve success rates that are as good or better than people that are considered fertile.
Specifically, the New England Journal of Medicine published data summarizing the results of nearly a quarter of a million women[r2] treated at centers throughout the USA. This is the best estimate of the average success since it does not reflect a specific group of women or the experience of one specific IVF center. What they found was very hopeful. Nearly 60% of the women that were undergoing treatment had a baby (live birth). In fact, 30% of the women that underwent ART had a baby following their first IVF attempt! The majority of those not successful on their first attempt; did achieve a success rate as high as or higher than those of fertile patients the same age. In other words, IVF is able to overcome most obstacles to achieving a successful pregnancy except those related to age and its impact upon egg quality. Even though live birth rates were lower when older women used their own eggs; the same study found a cumulative live birth rate of 60-80% when women used an egg donor—regardless of the age of the woman carrying the pregnancy and delivering the baby.
Other studies released the same week [r3] demonstrated that women that were experiencing anxiety or depression before IVF did not have a lower chance for achieving a pregnancy. However, they did find that a failed IVF cycle can exacerbate these problems. This further emphasizes the need to focus on the success rates achieved with repeat IVF cycles. Currently there are about 1.5 million ART cycles being performed globally each year resulting in the birth of about 350,000 new babies. The key to focus on is that success rates are very high but it can take up to 6 IVF attempts for couples with more complicated problems to actually have a baby. Clearly the path to parenthood for couples that need ART is repetition. That is why it is so important to make treatment accessible. Personally, I am proud to work at a center that offers treatment at the most competitive prices [r4] in order to make IVF treatment accessible to all of those that need/want it.
Robert Greene, MD, FACOG
CNY Fertility Center
e-mail me at firstname.lastname@example.org
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