In vitro fertilization (IVF) has been a miracle for so many women suffering from infertility. But if you aren’t successful on the first IVF cycle, how many IVF cycles should you try before throwing in the towel and moving on to another option to build your family?
Groundbreaking Research on How Many IVF Cycles Are Needed
Recent research, published in the The Journal of The American Medical Association, looked at a large number of women (almost 157,000) for a long period of time (from 2003 to 2012) in Britain to determine the likelihood of achieving a live birth after IVF. Specifically they were looking at how many IVF cycles were needed to achieve a live birth. The researchers included both fresh and frozen embryo transfers resulting from an egg stimulation and retrieval as one IVF cycle.
Researchers found that about two thirds (65.3%) of patients will be successful after six or more cycles of IVF. These results were particularly applicable to women under the age of 40.
What’s not to love about a large well designed study published in a prestigious medical journal? This is the type of study that usually sets my heart aflutter with joy not the anxiety that I actually feel.
Yes, I know this is not the correct response any self-respecting research geek. After all, research is research, and knowledge is power, and we should applaud any additional insight into infertility treatment and in vitro fertilization (IVF), but still my feelings are decidedly mixed.
Is this research telling you to try six, seven, eight, or nine cycles of IVF? Is this research going to be used by infertility clinics to make 6-9 IVF cycles the standard protocol regardless how many eggs a woman produces? Are infertility patients now going to feel like quitters and failures if they decide that 3 cycles is enough? Is the new IVF mantra going to be: If at first you don’t succeed, try try again?
How Many IVF Cycles Should You Try Before Stopping
In the past, most doctors discourage woman from continuing in treatment using their own eggs after about 3 to 4 failed IVF cycles. They are particularly discouraging for women who do not produce any eggs — or produce just two or fewer — with each cycle. This new study challenges both assumptions.
Dr. Debbie Lawlor, senior researchers for this study, said:
“These findings support the efficacy of extending the number of IVF cycles beyond three or four. … As the number of treatment cycles increased, the cumulative [success] rate across cycles increased up to the ninth. … We found that just isn’t the case [how many eggs a woman produces in each cycle]. Don’t give a load of importance to any one cycle.”
Dr. Scott Nelson, the other lead researcher further clarified:
“For most couples – and certainly those where the woman is younger than 40 and those of any age using donor eggs – two-thirds will achieve a live birth after five or six treatment cycles. This will take, on average, two years and is similar to rates that couples conceiving naturally take in one year.”
Responses to New Research on How Many Cycles of IVF are Best
I was a little surprised by the response of some in the media to this IVF research that “Hey, IVF doesn’t always work?!?” It’s easy for those of us immersed in the infertility world to forget that many people, including journalist, still think of IVF as a one and done procedure that almost always works. Ah, if only it were true.
The responses from the Creating a Family Infertility Support Group were less surprising.
- Ain’t nobody got time and money for that… [my favorite]
- Unless you are rich, who the heck has the money for that? It would be different if it were covered by insurance, but in most states like mine it is not covered at all.
- Six cycles is crazy. We conceived our IVF baby on our second IVF but that about broke the bank. No way could normal people afford six attempts. We have insurance now that covers 4 cycles of IVF but that is only four cycles, and I don’t know that I could put my body through 6 rounds of shots, retrievals, and most of all the crushing disappointment. It isn’t fun or easy.
- We only did one and it didn’t work. I was such an emotional mess I don’t think my marriage or my husband would make it through 6 cycles.
- Clearly they need to work on better methods. Are they making a lot of money off of desperate couples? Sorry to be a cynic, but it makes me wonder.
- I worry that this is going to become another way to put pressure on people to go beyond their limits and to say “well, you CHOSE not to have children” to people who really didn’t have much of a choice with the financial and emotional aspects inherent in IVF.
What’s an Infertility Patient to Do?
Infertility patients are between a rock and a hard place. Realistically, if financially and emotionally possible, they need to go into IVF with the expectation of multiple cycles rather than one. Each person/couple needs to assess how many IVF cycles they are willing to try, keeping in mind their diagnosis and prognosis, their finances, the physical toll treatment takes on a woman’s body both short term and long term, and what is best for them emotionally as individuals and (if married) as a couple.
Easy to say, but not so easy to do, especially considering the results of this research.
I am hoping this research will spur on other studies that will improve the success rates of IVF in general so that more women will succeed on the first or second try. It is simply not good for a woman’s body, her emotions, or her wallet to have to go through six to nine cycles of IVF.
I am also hoping that this research might change the payment structure for IVF treatments. Knowing how many cycles of IVF are truly needed for a successful pregnancy could encourage infertility clinics to include more cycles in their packages where you pay a lump sum to include up to a certain number of cycles.
Did anyone else feel queasy about the results of this research?
Other resources you might like:
- How Long Should You Try Fertility Treatment Before Stopping
- Five Ways to Know When It’s Time to Quit Fertility Treatment
- Infertility Dilemma: Are You Giving Up Too Soon
- The Infertility Treatment vs. Adoption Wars!?!?
Image Credit: stacylynn
Reading the study, I believe you have mischaracterized the findings – or at least it’s unclear. I know it’s an old post, but it’s top of google search, so I wanted to clarify things. The study does not say that 65.3% of women will get pregnant AFTER six or more cycles. It says: 65.3% of women achieved a live birth BY (emphasis mine) the sixth cycle, including about a third of women who achieved a live birth after one cycle. So while the study certainly does suggest that the limits of treatment should not be confined to 3-4 cycles, it does not say the majority of women needed more than six. About a third needed one, with cumulative odds increasing for each cycle. A useful graphic is shown on this page: https://pubmed.ncbi.nlm.nih.gov/26717030/#&gid=article-figures&pid=figure-2-uid-1
I have had 10 IVF transfers so far and will continue to do more. I know I will be able to have a baby, just haven’t yet, and I will not give up either. It has been very tough but me and my husband are a strong couple. I am lucky to have him. I do see a therapist since my depression got bad after my 9th transfer and it really does help. I am also lucky to have found a new doctor that wont give up on me either, and will have my first transfer with him in a few months. I am excited. The lab is key and this place has the best lab, and they do everything there including embryo testing. Hoping it was just bad labs before and this is key for us. We will see what happens.
We wish you the very best success while you work to build your family!
This is so inspiring. Having done 7 stim cycles, 6 transfers (of 9 embryos including 4 PGS, the rest untested), I need to hear about other women that are not giving up. I have immune issues hence the failed transfers but still making embryos and just turned 40. Have to believe there is hope!
I hate that you
Mention that IVF has been a miracle for WOMEN suffering from infertility. It’s completely wrong and stupid to put such stigma on women. It’s a couple’s problem.
Actually in my case I have had to take all these hormonal treatments when I am actually 100% fertile and it’s my partner who is not.
Things need to change, he should be the one taking treatments to stimulate his fertility. Not me. And people should stop putting all the responsibility on women, especially for such a website that wants to help families.
Thank you for reaching out and sharing your story. I’m sorry for your struggles. I hope your reproductive specialists are working a great plan for you and your partner to conceive and carry to term as you work to build your family.
IVF has been a miracle for many women – certainly not all – who wish to be mothers. Infertility is not just a couple’s problem, as many who struggle with infertility and pursue IVF are not part of a couple. Or are part of a same-sex couple with few other options for pursuing parenthood. Again, certainly not all women find it to be successful or miraculous but a good many do.
We wish you the best!
What is the reason behind first failure tof IVF if thera is not a problem in any thing
There are often many potential reasons that IVF fails, unique to each patient. We are not medical professionals so we can’t answer that for you. It’s a good question to ask your specialist.
I am doing no IVF treatments, and I know there are people that may not agree with thatr decisión. But it is something I thought about and debated over and did research on, and I do not feel emotionally or physically able to handle that challenge on 1 cycle much less 6!
Natalie, everyone has to decide what is best for them. It is no one else’s business to agree or disagree with your decision. Good luck on whatever the next step is for you.
Hi Dawn,
Thank you for this timely blog. In answer to your question “did anyone else feel queasy?” My answer is a resounding yes!. I’ve worked with thousands of IVF patients over the years who have done numerous IVF cycles just in case the next cycle is the one that produces a viable embryo. One woman did 18 cycles before she decide she was ready to move on to other options. Most people can’t afford to go through repeated cycles, and the majority of my clients are over the age of 40, yet they will ignore the age and latch on to the hope that maybe if they try a few more times… I think we have to remember that the focus of this study is on science not on the emotional wear and tear on the individuals who are wanting to become parents.
Just this week we had a couple who had read the results of this research who decided to try a few more times. They are over 40. Regardless of the research, their chances are still less than 5 percent. But they now feel compelled to try a few more times.
The goal is to have a child in your life. This is a quote from a woman who choose egg donation: “It took me almost 3 years to finally take the leap of faith to hope and believe everything would be ok. Fast forward, Mia is now almost 2.5 years old, and I love her with ALL my heart. Having conceived her through donor egg is without a doubt, 100% a non-issue. There’s just no way to truly understand this until you are on the other side.”
Thanks. Dawn, keep up the amazing work that you do to support individuals and couples struggling to create their families.
Gail Sexton Anderson, Founder, Donor Concierge
[we have to remember that the focus of this study is on science not on the emotional wear and tear on the individuals who are wanting to become parents.] YES! I would also point out that the researchers were clear that once a woman is over 40 the results didn’t hold.