Pursuing IVF is a significant investment of your energy, emotions, time, and finances. So, it makes sense that individuals and couples want to know how many cycles they should plan for from the outset of their treatments. The answer is not straightforward and varies from infertility diagnosis to diagnosis. However, we recommend planning for no more than three to four IVF cycles.

There are several reasons for this.

The Greatest Percentage of IVF Success…

After reviewing the data from millions of IVF cycles worldwide, researchers have determined the best chances of IVF success occur when couples commit to six cycles of IVF. If you’ve already read this research, odds are you gasped. Six IVF cycles? That is too much to ask of anyone – and we feel it jeopardizes our patients’ wellbeing.

The study came from the UK, where researchers reviewed the statistics of 156,947 UK women who received 257,398 IVF between 2003 and 2010. From that comprehensive analysis, which included fresh and frozen embryo transfer results, researchers found that the average live birth rate for couples participating in six IVF cycles was 65.3%.

However, that number is unreasonable and there have been large advancements in the IVF field. Beyond the financial costs of pursuing six or more IVF cycles, the overall toll is far too high on the patients.

Top Fertility Specialists Honor a 3 to 4-cycle Maximum

Over time, we’ve learned that couples should plan for no more than three to four IVF cycles. At that point, when IVF isn’t successful, we discuss other options. This is also why you’ll notice most IVF centers offer multiple-cycle discounts that run in two to four-cycle packages – keeping IVF more affordable.

Top fertility specialists tend to honor the three- to four-cycle cap. Here’s why:

Age matters

• Only women under 40 had a 65.3% chance of getting pregnant by six cycles.
• Women 40 and over only have a 1 in 3 chance of IVF success – even at the six-cycle mark.
• Women 42 and over had a less than 4% chance of IVF success – even after six cycles.

When carefully reviewing the study’s findings, we see that most patients are far better served by pursuing two to three cycles, and then regrouping.

If patients aren’t pregnant after two IVF cycles, we’ll use the information we learn to shape the following steps. This might look like using donor sperm, donor eggs, or even a donor embryo – depending on the diagnosis and IVF results.

Accurate diagnostics

After age, an accurate diagnosis is the foundation of fertility treatment success. All patients should undergo comprehensive infertility testing – including semen analysis (40% of infertility is related to abnormalities in sperm) by a fertility treatment center – leaving no stone unturned. Without this, you don’t the complete information for customized treatments.

If you’ve pursued one or two expert opinions and are still not pregnant after three to four cycles, it’s difficult to justify continuing with more IVF.

Some infertility diagnoses are more challenging than others

Even with a diagnosis, some diagnoses or reproductive histories are more complicated than others. For example, women who’ve carried a baby full-term in the past have higher rates of IVF success than women who have a history of repeat miscarriages (recurrent pregnancy loss). Women with endometriosis, PCOS, or blocked fallopian tubes tend to fare well using IVF as do women with partners who have a low sperm count.

However, women diagnosed with infertility due to particular types of fibroid tumors, uterine abnormalities, aneuploidy (eggs with an incorrect number of chromosomes), or ovarian dysfunction have the most challenging time and are the most likely to need repeat IVF cycles. Women with these diagnoses (or with partners carrying known genetic abnormalities) are also the least likely to get pregnant after three or four cycles without considering donor egg/sperm OR a gestational carrier (in cases where uterine abnormalities are the problem).

Lifestyle choices & overall wellbeing

Undoubtedly, lifestyle choices and overall health play a fundamental role in your ability to get pregnant. And that includes your partner’s choices too. This is especially true when pursuing IVF.

We spend a tremendous amount of time speaking to patients about this topic and do all we can to support them in making healthy lifestyle choices, including:

• A healthy diet
• Exercise
• Weight management (being underweight is as detrimental as being overweight/obese)
• Sleep habits
• Stress management

Steps You Can Take to Support IVF Success in Four Cycles or Less

Above and beyond your commitment to living well and taking good care of yourself, there are steps you can take to increase your chances of IVF success in four cycles or less:

Choose the best fertility specialist for you. We always perform our own comprehensive infertility testing because we can only trust our center’s test methods and results. That said, many patients come to us already knowing their infertility is at least partially the result of a specific condition – like endometriosis, PCOS, scarred fallopian tubes, etc. If this is the case for you, take the time to research fertility treatment specialists and centers carefully, only considering those with the highest success rates for women in the same age bracket – and with a similar diagnosis.

Take advantage of Preimplantation Genetic Screening. Preimplantation Genetic Testing (PGT) has become a new normal for couples pursuing IVF. During these tests, we take a cell sample of the blastocyst. Embryologists test for chromosomal and some of the most common genetic abnormalities. You can expand this test to include more than the usual genetic defects/diseases to optimize the health of transferred embryos further.

While these tests do cost more, they can increase your chances of successful IVF outcomes or can help you make the decision to use donor eggs if a significant number of embryos test positive for chromosomal/gene abnormalities.

Consider using donor sperm, eggs, or embryos. Listen to your fertility specialist and take note if they mention or suggest using donor sperm, frozen donor eggs, or embryos. We understand this isn’t most couple’s first choice. However, we never suggest it unless we feel going the third-party IVF route will notably increase your chances of pregnancy. Using donor eggs is much more likely to increase your chances of a live birth outcome if you are 40 years or older.

Similarly, donor sperm, eggs, or embryos may also be recommended if a PGT demonstrated a significant number of blastocysts tested positive for aneuploidy or when evidence suggests sperm, egg, or embryo quality are the reason for repeat cycle failures.

Follow your fertility specialist’s advice. Sometimes, our patients’ dreams and desires to have their babies or build their family exactly as they envisioned interrupt the reality of what’s going on in their bodies and which options make the most sense given their diagnosis, reproductive history, or previous treatment cycle failures.

Even when it’s hard, your fertility specialists’ recommendations are 100% geared towards taking the best care of you – and optimizing your best chances for becoming parents.

Start Planning For Multiple IVF Cycles with RRC

The Reproductive Resource Center has the highest IVF success rates in the region, and Dr. Brabec repeatedly wins awards for her achievements in the field of fertility. This is 100% related to our diligence in getting accurate infertility testing results, tailoring our treatment programs, and being honest with clients when we feel third-party reproduction is their best chance.

Contact us to schedule an appointment, and begin planning for multiple IVF cycles, and we promise to give you nothing but honest information, recommendations, and feedback.