An online calculator can estimate the chances of live birth throughout courses of in vitro fertilization (IVF), both before treatment and after the first fresh embryo transfer, according to a study in BMJ.
David J McLernon, PhD, from the University of Aberdeen in the UK, and colleagues identified 113,873 women undergoing cycles of IVF in the UK from 1999-2008 using their own eggs and partner’s sperm. Also included in the cohort were women who received intracytoplasmic sperm injection (ICSI).
Two clinical prediction models were developed to estimate the chance of a first live birth over a maximum of 6 complete cycles of IVF: one model using information available before starting treatment and the other based on additional information collected during the first IVF treatment. A “complete cycle” is defined as all fresh and frozen embryo transfers arising from 1 episode of ovarian stimulation.
Pretreatment predictors of live birth were the woman’s age (31 v 37 years) and duration of infertility (3 v 6 years). Post-treatment predictors included number of eggs collected (13 v 5 eggs), cryopreservation of embryos, the woman’s age, and stage of embryos transferred.
The total number of women who participated in the study had 184,269 complete cycles of IVF. A total of 33,154 (29.1%) had a live birth after the first complete cycle and 48,925 (43.0%) had a live birth after 6 complete cycles. However, the chances of a live birth over 6 complete cycles were lower after transfer of a single cleavage stage fresh embryo compared with double cleavage stage fresh embryo. Thirty percent of all live births resulted in multiples.
Couples with a diagnosis of tubal or male factor infertility had a 10% reduced chance of a live birth, whereas couples with unexplained infertility or anovulation had a slightly increased chance of success. Couples without a previous pregnancy had slightly decreased odds of live birth, and couples who underwent ISCI had a 24% increased chance of live birth as opposed to IVF alone.
According to the authors, “This study has developed a novel calculator that can predict the cumulative chances of a live birth for an individual couple over a package of complete IVF cycles. This tool will help shape couples’ expectations, allowing them to plan their treatments more efficiently.”
McLernon DJ, Steyerberg EW, te Velde ER, Lee AJ, Bhattacharya S. Predicting the chances of a live birth after one or more complete cycles of in vitro fertilisation: population based study of linked cycle data from 113 873 women. BMJ. 16 November 2016. doi: http://dx.doi.org/10.1136/bmj.i5735