“What are the chances of IVF working the first time around?” This is the question anyone, starting IVF really wants to know.
We turned to Dr Harry Hiniadis, Consultant Reproductive Gynecologist and Vice President at Hygeia IVF Embryogenesis.
Can you start by giving us the statistics…how likely is it that a round of IVF will work?
Nowadays, IVF success rates have significantly improved because of advances both in laboratory technology and embryo culture media. Therefore for ages up to 35, the expected success rate is 50-60%. Between 35-36 years, we expect success rates up to 40% and for ages 40-41, between 10-15%.
It is well known that after the age of 38, we observe a deterioration in the quality of oocytes produced by the future mother, which unfortunately plays a significant role in low success rates from then on.
Why is it that IVF rarely works on round one?
Statistically, this is self-explanatory. Considering that the average age of a woman having IVF treatment is more than 37 years old, where the success rate is approximately 35%, the rest -that is 65%- will not achieve a pregnancy in the first attempt.
However, in women younger than 35 years, the majority will have a positive test with the first IVF treatment.
Needless to say that not all IVF clinics are the same. Patients should research and find an experienced gynaecologist specialising in fertility treatment and an IVF centre with an excellent laboratory following modern techniques and guidelines.
Why is it that, on average, it takes 3 rounds of IVF to achieve success?
In general, we assume that a patient of any age has a 70% chance of becoming pregnant within her first 3 attempts. Hence the aforementioned myth.
In reality, depending on the maternal age and the infertility reason, most couples achieve a pregnancy without undergoing 3 treatment cycles.
What do you as a doctor do differently between rounds?
In the first IVF treatment, we organise a protocol that matches criteria collected by medical history and infertility investigations, e.g. maternal age, sperm quality, hormonal profile, tubal patency, BMI, ultrasound scan findings etc.
Following that cycle, in case of a negative result, we have more data regarding the couple and especially the ovarian response to the stimulation, egg and embryo quality, difficulties in the embryo transfer procedure etc.
The doctors’ experience and the way they interpret this new information play a significant role in the changes and the fine-tuning of the treatment that is going to give a positive result in the following cycle.
Do your chances of success increase with each round that you have?
In most cases, yes. As mentioned above, we can change medication, treatment protocol, perform further investigation -embryo biopsy- and diagnostic or surgical procedures like hysteroscopy and laparoscopy.
However, sometimes there is no space for significant improvement. For example, in patients with low ovarian reserve or advanced reproductive age, where the quality of the oocytes is the main problem, the only solution is often the use of donor eggs.
Is there anything a man or woman can do to increase their chances of IVF working?
The answer is yes. The most significant thing is to obtain a healthy lifestyle. Avoid smoking, maintain a normal BMI, exercise, attend the yearly gynaecological follow-up and listen to your doctor’s advice.
Family history plays an important role too. For example, if your mother or sister had an early menopause, you have to consider it and let your doctor know.
Finally, we all need to understand that maternal age is crucial in fertility treatment. IVF is a reproductive technology that has limitations, and women should not believe that it is easy to become pregnant at the age of 40 by undergoing such a treatment.
Hence we -doctors- need to inform our patients how fertility changes as time goes by and explain to them the available options.