Under right conditions, fertility treatment can equal natural conception rates: study

June 27, 2012 By Jenifer Goodwin, HealthDay Reporter
Under right conditions, fertility treatment can equal natural conception rates: study
Older women would do well to consider using donor eggs from a younger woman.

(HealthDay) -- With enough cycles and the right egg and age of a woman, the chances of in vitro fertilization resulting in a baby approaches that of natural conception, a large new study finds.

A woman's age is the best predictor of whether in vitro fertilization will result in a baby, with under age 34 having the greatest chances of success. But can largely overcome poorer odds by using from a younger woman, according to the research.

Those are among the findings of a massive study on in vitro fertilization that, while offering few surprises, provides what experts say is the most detailed, nuanced look at who is likely to be successful using assisted reproductive technology.

"What this study does is look at a woman's chances of conception based on adding all cycles together and taking into account her age, the that brought her in for fertility treatments, whether there were additional [preserved] and the stage the embryos were transferred," said lead study author Barbara Luke, professor and at Michigan State University in East Lansing. "When women come in for treatment, there isn't a simple answer about their chances of conception. There are a lot of factors to be taken into consideration."

For example, after the third treatment cycle, women aged 31 and younger had a 63 percent to 75 percent chance of ending up with a baby, while women 41 or 42 using their own egg had a 19 percent to 28 percent chance. Those 43 or older had a 7 percent to 11 percent chance.

When donor eggs were used, the rates were much higher -- 60 percent and 80 percent, respectively, for all ages.

"If you use a younger egg, you will vastly improve the chances of conception," Luke said.

In other findings: The chances of getting pregnant were higher when physicians transferred a "blastocyst embryo" (an embryo that is five to six days old) instead of a " embryo" (one that is two to three days old). At the third cycle, live-birth rates were 52 percent to 81 percent for blastocyst embryos and 43 percent to 65 percent for cleavage embryos.

The study, published in the June 27 issue of the New England Journal of Medicine, looked at data on nearly 250,000 women who underwent 471,000 in vitro fertilization cycles from 2004 to 2009 at approximately 400 clinics. The treatments resulted in 141,000 babies. The data was from the Society for Clinic Outcome Reporting System.

Rather than look at the likelihood of success per cycle, the researchers were able to track women over several years to determine their cumulative rates of success -- that is how likely they were to get pregnant and carry a baby to term on subsequent in vitro fertilization cycles if their first, second or even third cycle was unsuccessful.

Many women quit after one or two cycles, often because of stress, discouragement or finances. One cycle of in vitro fertilization costs approximately $10,000 to $12,000. The study findings, which included women who had up to seven or more cycles, suggested some may be giving up too soon, Luke said.

About 25 percent of women quit after the first cycle, and about one-third of the remainder quit after two cycles, Luke said.

"One of the messages to take away from this is to think about infertility treatment as a course of treatment that, for most women, will take more than one cycle," she said. "This is showing your success rate may be right around the corner. One more try may do it."

By the same token, women 40 and older should take a hard look at their odds and perhaps consider a donor egg more quickly, she added.

The new study also looked at infertility diagnoses that could influence chances of success. Having a low number of eggs or a diagnosis of diminished ovarian reserve was associated with lower odds of a live birth. Uterine factors -- such as fibroids, endometriosis or adhesions on the uterus -- also were associated with a markedly lower success rate.

Other factors, such as male infertility, polycystic ovarian syndrome and tubal factor infertility, had less of an impact, the study found.

Dr. William Gibbons, former president of the American Society for Reproductive Medicine and director of the division of reproductive endocrinology at Baylor College of Medicine in Houston, said the new study was unprecedented in that it involved such a large number of women.

He also commented that the data enabled researchers to track women over time to determine the overall chances of success based on a variety of factors.

Couples want to know their chances of ultimately having a baby, and if it makes sense for them to continue going through the expense and stress of multiple in vitro fertilization cycles, Gibbons said. One major message from the study is that an older woman's chances of getting pregnant after three cycles are pretty similar to a younger woman's chances if the older woman is willing to use a donor egg, he said.

The new statistics will enable doctors to give more detailed information to couples as they make their decision about whether they want to keep going with in vitro fertilization, to turn to donor eggs or to keep trying with their own.

"We can show this to couples, and it can be used in counseling patients," Gibbons said.

Explore further: More US women having twins; rate at 1 in 30 babies

More information: The U.S. National Library of Medicine has more on in vitro fertilization.

Related Stories

More US women having twins; rate at 1 in 30 babies

January 4, 2012
More U.S. women are having twins these days. The reason? Older moms and fertility treatments.

Study finds no better odds using 3 embryos in IVF

January 12, 2012
A new study of fertility treatment found that women who get three or more embryos have no better odds of having a baby than those who get just two embryos.

Recommended for you

Negative birth outcomes linked to air pollution exposure early in pregnancy, study finds

July 27, 2017
Exposure to air pollution early in a pregnancy could increase risk for preterm birth and low birth weight, according to a study led by researchers at NYU School of Medicine, and published on July 27 in Environmental Health ...

Study shows a significant ongoing decline in sperm counts of Western men

July 25, 2017
In the first systematic review and meta-analysis of trends in sperm count, researchers from the Hebrew University-Hadassah Braun School of Public Health and Community Medicine and the Icahn School of Medicine at Mount Sinai ...

Women exposed to smoke while in womb more likely to miscarry

July 13, 2017
Women exposed to cigarette smoke while in their mothers' wombs are more likely to experience miscarriage as adults, according to new research from the University of Aberdeen.

Lack of a hormone in pregnant mice linked to preeclampsia

June 30, 2017
(Medical Xpress)—A team of researchers from Singapore, the Netherlands and Turkey has isolated a hormone in pregnant mice that appears to be associated with preeclampsia—a pregnancy-related condition characterized by ...

Aspirin reduces risk of pre-eclampsia in pregnant women

June 28, 2017
Taking a low-dose aspirin before bed can reduce the risk of pre-eclampsia, which can cause premature birth and, in extreme cases, maternal and foetal death.

The biology of uterine fluid: How it informs the fetus of mom's world

June 22, 2017
A developing fetus bathes in a mixture of cellular secretions and proteins unique to its mother's uterus. Before fertilization, the pH of uterine fluid helps create a conducive environment for sperm migration, and afterward, ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.