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).
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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.”
Reference
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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
