Live-Birth Rate as a Measure of IVF Success

Summary and Comment |
January 14, 2009

Live-Birth Rate as a Measure of IVF Success

  1. Sandra Ann Carson, MD

Cumulative live-birth rate could be a practical means of evaluating potential for a live birth across multiple cycles.

  1. Sandra Ann Carson, MD

In vitro fertilization (IVF) databases often cite pregnancies per cycle as an indicator of clinical success. However, this marker might not help patients evaluate the potential for a live birth across multiple cycles. In a retrospective cohort study that involved 6164 patients who underwent their first fresh-embryo IVF cycles at a single practice (>14,000 IVF cycles), investigators evaluated an alternative assessment that could provide IVF patients with a more useful measure of their chances for pregnancy. The primary outcome was the delivery of ≥1 live infants in ≤6 cycles. An “optimistic” live-birth rate was calculated based on the assumption that patients who did not return for subsequent IVF cycles had the same probability of pregnancies that resulted in live births as did patients who continued treatment; a “conservative” live-birth rate was calculated based on the assumption that patients who did not return for treatment had no live births.

The overall cumulative live-birth rate after 6 cycles was estimated to be 72% with the optimistic method and 51% with the conservative method. Stratification of results by age showed that, among patients who were <35 at the time of their first cycles, the optimistic and conservative live-birth rates were 86% and 65%, respectively. Women who were ≥40 had optimistic and conservative live-birth rates of only 42% and 23%.

Comment

The authors note that the true live-birth rate probably fell between the optimistic and conservative estimates. Nonetheless, this outcome measure allows patients to assess their chances for live births across multiple IVF cycles. The large sample size supports previous findings of diminishing fertility with a woman’s advancing age despite assisted reproductive treatment. However, because the data are practice-specific and the study excluded common interventions (such as donor oocytes or surrogacy), the results might have limited applicability. Nevertheless, the investigators’ proposition that cumulative live-birth rates offer a more practical estimate of IVF patients’ chances of live births deserves attention.

Citation(s):

Your Comment

(will not be published)

Filtered HTML

  • Allowed HTML tags: <a> <em> <strong> <cite> <blockquote> <code> <ul> <ol> <li> <dl> <dt> <dd>
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Do you have any conflict of interest to disclose?
CAPTCHA
This question is for testing whether you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

* Required

Reader comments are intended to encourage lively discussion of clinical topics with your peers in the medical community. We ask that you keep your remarks to a reasonable length, and we reserve the right to withhold publication of remarks that do not meet this standard.

PRIVACY: We will not use your email address, submitted for a comment, for any other purpose nor sell, rent, or share your e-mail address with any third parties. Please see our Privacy Policy.

Sandra Ann Carson, MD

Past Editor-in-Chief, Past Deputy Editor