Predicting Success with IVF

What are your odds of getting pregnant with In Vitro Fertilization? Should you try another cycle of IVF? What are your odds of success? Our guest is Dr. Mylene Yao, co-founder and CEO of Univfy Inc., a company that develops personalized prognostics for fertility patients and physicians. In her previous role as a National Institute of Health (NIH)-funded assistant professor at Stanford University, Palo Alto, CA, Dr Yao, together with her scientific collaborator and co-founder Professor Wing Wong, developed deep phenotype profiling as an approach to in vitro fertilization (IVF) prediction modeling. We also have with us Dr. David Seifer, Clinical Professor in the Department of Obstetrics and Gynecology at New York University School of Medicine in New York City, Scientific Director of the Division of Reproductive Endocrinology and Infertility at Maimondies Medical Center and Co-Director of Genesis Fertility and Reproductive Medicine in New York City.

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  • If we look at all IVF cycles, excluding donor egg cycles, what are the odds for a live birth?
  • Is there is any research to say how many fresh IVF cycles a person should try before the odds of success are simply unreasonable? What’s the magic number of in vitro cycles before you give up?
  • There are many factors that are in play when deciding whether to try IVF either the 1st time or repeated times, finances and emotional strain, not the least that are often considered. But certainly a huge factor is the likelihood of getting pregnant and giving birth to a healthy baby. In the past most prediction models were based heavily on the age of the woman—or more specific the age of the egg. What factors do you now consider?
  • What information that is standard in the medical records of most infertility patients can be used to predict In Vitro Fertilization success?
  • What information can be gained from a failed IVF attempt that can be used to predict whether a patient should try another IVF cycle?
  • Is age still one of the most important factors in determining whether IVF or other infertility treatment will work?
  • Are your chances of getting pregnant with infertility treatment higher than average if you were successful the first IVF cycle?
  • What are the most important factors in predicting success with in vitro fertilization?
  • How important is AMH, or antimullerian hormone, at predicting live birth?
  • Does it make sense for a women in her early 30’s who wants to wait to have children to have specific tests to determine her ovarian reserves and effective ovarian age? If so, what tests should be run?
  • How important is the husband’s age as a factor in whether IVF will be successful? Does a man’s age affect chances of getting pregnant?
  • Is using an IVF prediction model any better than simply talking with your reproductive endocrinologist?
  • Are prediction models only available to infertility clinics and doctors?
  • How important is the rate of embryonic cell division in selecting the optimum embryos to transfer? Do infertility clinics and labs routinely report this data now?
  • How good are we now at choosing the embryos to transfer? We have heard in the past on this show that it is more art than science. So, how good are we now at assessing embryo quality?
  • Is prediction of future success primarily used with second IVF attempts rather than the first try?
  • For patients that have had repeated failures to implant or recurrent miscarriages, how effective is PGD now at predicting which embryos are more likely to implant and result in a live birth?
  • Is it best to perform PGD on a Day 3 embryo or Day 5 blastocyst?
  • What is the disadvantage of waiting until Day 5 to perform pre-implantation genetic diagnosis?
  • How important is BMI (Body Mass Index) in determining whether infertility treatment will be successful? Is there a specific BMI beyond which you should not try IVF?