How Many Times Should I Try IVF?

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Emotional and financial cost aside, there is strong evidence supporting the use of IVF again after an unsuccessful cycle, with some research pointing to three cycles as the optimal number.

The Increasing Use of IVF

Between 2005 and 2014 alone, the US saw an increase of about 26% in ART use. Not only is the use of ART increasing, technological advances and ongoing procedural improvements mean that it is becoming more effective. Between 2005 and 2014, the number of live births resulting from ART increased by nearly 150%

 

What are the Success Rates of IVF?

The chart below shows success rates for ART cycles using fresh, non-donor embryos. As you can see, the female's age is the primary indicator of how successful a cycle will be. However, even women under 35 only average  a 37% success rate. This illustrates that couples should not approach IVF as something that will guarantee a successful pregnancy on the first try.

 ART Live Birth by Age.png

Source: https://nccd.cdc.gov/drh_art/rdPage.aspx?rdReport=DRH_ART.ClinicInfo&ClinicId=9999&ShowNational=1

 

Am I More Likely to Get Pregnant After Multiple Cycles of IVF? 

Studies examining the likelihood of pregnancy after multiple IVF attempts show varied results, with some suggesting that three rounds is the optimal maximum, given the emotional and financial strain that IVF can cause. 

Financial limitations aside, it may be worth continuing beyond three cycles.

One recent study from the UK which looked at 184,269 complete cycles, found that in aggregate, there was a 29% chance for a live birth after one cycle, while the chance for a live birth went up to 43% after six complete cycles. These numbers are also variable depending on age. For example, a 30 year old couple with primary unexplained infertility has a 46% success rate in their first cycle, but a 93% success rate over 6 cycles.

This means that, where the general prognosis is good over time, there is likely a cumulative effect.

 Test for Poor Embryo Development

 

Risks of Multiple IVF Attempts

A study published in the Canadian Medical Association Journal showed a strong association between those who had undergone several rounds of IVF and did not get give birth and those who later had cardiovascular complications. This led to a belief that IVF could cause heart disease and stroke. But researchers acknowledge that while there may be a correlation between the two, IVF is not necessarily the cause of resulting cardiovascular issues.

It may be that people who already have cardiovascular problems also have less of a chance of getting pregnant in the first place. So these results may actually be an indicator of other issues that could factor into infertility and be a part of the decision of whether to undergo IVF in the first place.

There is a potential that IVF could cause longer term health effects that have not been researched yet. Beyond that, IVF does come with some risks such as medication / hormonal side effects, multiple births and Ovarian Hyperstimulation Syndrome.   

One considerable risk is that associated with multiple births which result from multiple embryo transfers. Women sometimes will opt for double or multiple embryo transfers instead of undergoing multiple rounds of IVF. However, risks associated with multiple pregnancies and births can be negated opting for single embryo transfers only.

 

Can I Improve my Chances of Getting Pregnant for a Second or Third Round of IVF?

It is important that your practitioner investigates possibilities as to why the first round was unsuccessful before trying a second attempt, as there are so many complex variables to consider.

One source of fertility problems that is often overlooked is the male. Female age is generally accepted as the single most important factor in determining fertility, but that doesn't mean problems on the male side can't contribute as well. If a couples has undergone IVF, then it is likely the male partner has completed a semen analysis. However, a semen analysis is a poor predictor for male fertility, and only reveals the most obvious male fertility problems.

Problems in sperm DNA can lead to poor embryo development. If you have failed an IVF cycle, and are diagnosed with unexplained infertility, take a closer look at sperm quality.

Seed is an epigenetic test for male infertility that looks sperm DNA to predict risk for poor sperm function and poor embryo development. With the insights from this test, you and your doctor may be able to adjust your treatment approach ahead of your next cycle.