How many IVF cycles are needed for success
How many IVF cycles are needed to achieve a pregnancy? How many should you plan on when going into fertility treatment?

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?

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Image credit: stacylynn