How many attempts should you try through IVF?

Conceiving a child proves to be difficult for more than 40 percent of males, and 40 percent of females, in fact 1 in 6 couples have difficulty becoming pregnant. If you suffer from infertility, you still have options available. In Vitro Fertilization (IVF) is one medical procedure that you can have to increase your chances of conceiving a child. This process allows you to use your eggs or sperm to conceive a child outside of the body. Once the eggs have been fertilized, the fertility specialists will insert a fertilized egg (now called an embryo) inside the uterus and wait to see if the procedure has been successful.

Most individuals that have the In Vitro Fertilization procedure will keep trying until they are successful. There is no guarantee that the procedure will work after the first or second cycle. In fact, the procedure may not work at all; however, 50 percent of individuals and couples who have IVF are successful. Some couples are lucky after the first cycle, but a large percent are not.

For this reason, you may need to keep on trying. The research suggests most couples will need approximately 6 embryo transfers before they achieve a pregnancy; because of the emotional, physical, and financial toll exacted by IVF, it is preferable that a couple undertake the process with the mindset that they will be in it for more than one attempt. If a couple can only afford one treatment cycle, IVF may not be the right course of action. Recall that on average, with conventional IVF, there is only about one chance in three that it will result in a live birth, and there is a tremendous letdown if it fails. It is thus unreasonable to undergo IVF with the attitude that “if it doesn’t work the first time, we’re giving up.” In vitro fertilization is a gamble even in the best of circumstances.

Statistically speaking, a woman under 40 years of age, using her own eggs, having selected a good IVF program is likely to have a better than 70% chance of having a baby within three completed attempts – provided that she has adequate ovarian reserve, (the ability to producing several follicles/eggs in response to gonadotropin stimulation), has a fertile male partner (or sperm donor sperm) with access to motile sperm, and has a normal and receptive uterus capable of developing an “adequate” uterine lining. Women of 39-43 years of age, who meet the same criteria, will likely have about half that chance (35%- 40%).

There are no limits to the number of IVF cycles you can have. This decision is entirely up to you and the fertility specialists. Of course you want to be healthy when you have the IVF cycles, or there is a higher chance of the cycle not being successful. Some couples have had more than 10 IVF cycles, while others have stopped after their first cycle; the decision is yours.  You can decide on the number of IVF cycles you have, but you need to be aware of the out of pocket costs associated with IVF. When the most “competent” embryos are selected for transfer using a new genetic process, known as comparative genomic hybridization (CGH), the birth rate per single, completed IVF cycle is likely to exceed 60% regardless of the age of the egg provider and, more than 85% within three such attempts.

Unfortunately, there will inevitably always be some women or couples who in spite of best effort at conventional IVF will unfortunately remain childless. In my considered opinion, it rarely advisable to undergo more than three IVF attempts using the same approach each time. There is of course one important caveat: in women where the reason for repeated IVF failure is finally uncovered, it would indeed be justifiable assuming there are sufficient emotional, physical and financial resources to continue trying, using a defined and new approach that addresses the reason for prior failures. Simply stated, “The time to stop trying is when there is no remediable explanation for repeated failure to achieve a viable pregnancy”.

When conventional IVF with or without egg donation and/or CGH embryo selection fails to yield a successful outcome, other options such as ovum donation, IVF surrogacy, or adoption should be considered. Although it is the right of any healthy women who has a uterus and is capable of producing even one follicle-egg to have the right to decide on doing IVF using her own eggs, given the very low success rate after 43 years of age (less than 10% per attempt and under 25% within 3 tries) it is our opinion that women over 43 years should be advised to rather do egg donor IVF. Here, regardless of the age of the embryo recipient, the IVF birth rate after a single attempt is about 60% and better than 80% within three IVF attempts.

Couples who choose to undergo IVF should be encouraged to view the entire procedure with guarded optimism, but nevertheless must be emotionally prepared to deal with the ever present possibility of failure. It is important for IVF patients to be made to realize from the outset that an inability to become pregnant should never be considered a reflection on them as individuals. There is no real age limit for women undergoing In Vitro Fertilization as long as the woman has not gone through menopause (in this instance donor eggs would need to be used). Many women in their 40s have the IVF procedure although positive results at this age are not very high. It has been reported that more than 10,000 cycles of IVF have been given to women who are over the age of 40. Out of those cycles, only 12 percent used donor eggs, but the other 88 percent used their own eggs for the IVF procedure. You have approximately a ten percent chance of having a baby through IVF if you are between the ages of 40 and 44.