Treatment-Independent Live Birth Common After Unsuccessful in Vitro Fertilization

By Will Boggs MD

August 06, 2019

NEW YORK (Reuters Health) - Many women whose in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatments are unsuccessful go on to achieve live births without further treatment, according to a retrospective study.

"It is reassuring that 1 in 6 couples who have experienced a negative outcome following their IVF journey still have a chance of having a baby naturally," Dr. David J. McLernon of the University of Aberdeen, in the U.K., told Reuters Health by email. "However, these chances decrease with age and are lower for couples who have been trying to conceive for a long period of time."

The success rate per cycle of IVF in the U.K. is around 27%. Most women discontinue treatment after their first attempt due to the psychological and physical burden of treatments, as well as financial constraints. There is limited information about treatment-independent live birth rates after IVF/ICSI treatment.

Dr. McLernon and colleagues examined data on 1,060 women who had a live birth resulting from IVF treatment and 1073 women whose treatment did not result in a live birth. The women were seen at a single IVF center, the only one in the region.

During a maximum follow-up of 15 years (median, about six years in both groups), 185 of the unsuccessfully treated women and 151 of the successfully treated women had at least one treatment-independent live birth.

The treatment-independent live birth rates among unsuccessfully and successfully treated women were 10% and 4%, respectively, at one year; 15% and 11% at 2.5 years; 17% and 15% at five years; and 19% and 17% at 10 years, the researchers report in Human Reproduction, online July 15.

The time to treatment-independent live birth was longer for successfully treated women. The researchers speculate that women who had the desired child through fertility treatment might have been less likely to try to get pregnant again soon after having a live birth and might have used contraception for a period of time.

Among both successfully and unsuccessfully treated women, increased female age, increased duration of infertility and ICSI versus IVF treatment were independently associated with a lower chance of treatment-independent pregnancy.

Tubal factor as a cause of infertility was associated with the lowest chance of pregnancy, while ovulatory disorder was associated with the best chance.

"Physicians (can) inform couples with no proven barrier to conception that they still have a chance of having a baby after unsuccessful IVF," Dr. McLernon said.


Hum Reprod 2019.