An important medical and ethical issue is to determine the efficacy of in-vitro fertilisation (IVF) following one or several fertilisation cycles. In other words, the likelihood of a woman giving birth to a live child after three or more fertilisation cycles in a IVF clinic, i.e. the efficacy as regards having a child for a woman attending an IVF clinic for fertility problems.

Few studies to date have addressed this issue. Only one paper published in the New England Journal of Medicine (366; 2483-2491, 2012) has reported the cumulative birth rate following several IVF cycles.

An extensive study has now been published (JAMA, 314; 2655-2662, 2015) addressing this issue.

The first thing that stands out in the study is the sample size: from an initial sample of 235,000 women who used IVF in the United Kingdom between January 2000 and June 2012, 156,947 were eventually included, following detailed sample selection.

The most notable finding was that the cumulative birth rate was 65.3% after six ovarian stimulation cycles, albeit with wide variations according to age and treatment type. This would therefore be the likelihood of achieving a live birth for an English woman attending an assisted procreation clinic in the United Kingdom, after three or four ovarian stimulation cycles.

However, as mentioned, these percentages depend greatly on the woman’s age. In women under 40 years of age using their own oocytes (eggs), the live birth rate after the first cycle was 32.2%, but in women aged between 40 and 42 years, the live birth rate after the first cycle was only 12.3%, and after six cycles was 31.5%. For women older than 42 years, the live birth rate for each cycle was less than 4%.

This very enlightening study gives us a real sense of the probability of having a child for a woman with infertility problems attending an assisted reproduction clinic, a probability that is generally much lower than that offered by the assisted reproductive clinics themselves in their advertising brochures.

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