First child conceived via assisted reproductive technology predicts future success
The cumulative live birth rate for women who returned to assisted reproductive technology to successfully conceive once again was between 50.5% and 88.1%, researchers reported in Human Reproduction.
“Patients commonly return to [assisted reproductive technology (ART)] after the birth of their first ART-conceived child,” Repon Paul, BSc(Hons), MS, a biostatistician and epidemiologist at the University of New South Wales in Sydney, and colleagues wrote. “To our knowledge, there are no published data to facilitate patient counseling and clinical decision-making regarding the success rates for these patients.”
Researchers analyzed data from 15,325 women (median age, 36 years) in Australia and New Zealand who used their own oocytes for ART treatment, had their first treatment-dependent live birth between 2009 and 2013 and returned to ART treatment by December 2015. Depending on when she gave birth to the second child, the woman’s pregnancy and birth progress were followed for 2 to 7 years. Researchers only included live births — at least one live infant of at least 20 weeks’ gestation or a minimum of 400 g birth weight — that occurred up to October 2016.
Paul and colleagues found that after six complete cycles, plus any surplus frozen embryos, the cumulative live birth rate for women who returned to ART with a frozen embryo was between 60.9% (95% CI, 60-61.8) and 88.1% (95% CI, 86.7-89.5; inverse probability weighting = 87.2%; 95% CI, 86.2-88.2). Comparatively, the cumulative live birth rate for women who commenced with a new ovarian stimulation cycle was between 50.5% (95% CI, 49-52) and 69.8% (95% CI, 67.5-72.2; inverse probability weighting = 68.1%; 95% CI, 67.3-68.9).
The adjusted odds of a second ART-conceived live birth decreased for women aged at least 35 years, those who waited at least 3 years before coming back to treatment or who needed a higher number of ovarian stimulation cycles or double embryo transfer to successfully conceive their first child. The estimates did not fully account for individual prognostic factors, such as BMI, duration of infertility and ovarian reserve, researchers wrote.
Georgina Chambers, PhD, MBA, director of the National Perinatal Epidemiology and Statistics Unit at the University of New South Wales in Sydney, said the findings underscore the need for patience in couples who undergo in vitro fertilization.
“ART treatment should be considered as a course of treatment, rather than just one single cycle of treatment,” she said in a press release. “If couples do not achieve a pregnancy in the first cycle, it could very well happen in the next. However, it would be best not to wait too long, especially if a new stimulation cycle is needed.”
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The authors of this paper estimated the chances of having a second child in women from Australia and New Zealand who returned for further treatment after having a baby conceived through IVF.
The study confirms previous research showing that women who conceive following IVF have a higher chance of pregnancy in a subsequent treatment. While the chances of live birth in this group appear very encouraging, the authors highlight the fact that women in the study represent a good prognosis group who are younger, respond well to hormonal treatment by producing a higher number of eggs and have spare embryos in the freezer.
The results of the study will aid clinical decision-making about further treatment in women seeking further IVF to complete their families but cannot be used to predict individual chances of success. The findings are reassuring for infertile couples — particularly in settings where funding is not a barrier to accessing multiple cycles of IVF.
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