How Many IVF Cycles Should I Plan For?
Posted on January 19, 2016
Making the decision to proceed with in vitro fertilization (IVF) is a major milestone in a patient’s fertility journey. Once you have made the decision, you are then confronted with another daunting obstacle: how to finance the endeavor. Your head will probably be spinning, once you hear about all the financing options, one of which may include a “package deal” for prepaying multiple IVF cycles in advance, in case you don’t, unfortunately, conceive during your first cycle.
As a patient, you may be faced with the question of how many cycles it may take before pregnancy hopefully occurs, and also, a decision about how many cycles to plan for, both emotionally and financially. The answer is not one-size-fits all, nor is it simple. But, a look at a new medical review may help provide additional information you can use.
The Recent Data
The review, recently published in the Journal of the American Medical Association (JAMA Dec 22/29 2015 Vol 314 No 24), looked at live birth rates resulting from IVF treatment and cumulative birth rates with repeated IVF cycles. Researchers found a 29.5% live birth rate for the first cycle, and by the 6th cycle 65.3% of study participants had achieved a live birth. According to reported findings, the cumulative live birth rate actually increased for up to nine cycles, which may support trying more than one or two IVF cycles, should they fail. The study, while significant, should not be utilized by patients or physicians to support a cookie cutter response to the number of IVF cycles attempted.
What Does It Mean For Patients?
Of course, in clinical practice it is not the norm to see patients attempting six to nine IVF cycles. Many get pregnant within the first few cycles, many don’t have the financial means to do multiple cycles, and many decide to move on to other options like egg donor IVF or adoption. Others get discouraged from the repeated attempts. The best way to determine how many cycles you may need to do is to discuss it with your physician.
Your physician can review your medical history and give a reasonable expectation of how to plan your fertility treatment. Unfortunately, your doctor cannot predict with complete accuracy how you will respond to treatment or predict if you will conceive the first time. They can only give an assessment based on your medical history, and even that is just an estimate. Patients often get frustrated not being able to get answers to their questions.
What Might It Mean For You?
With fertility, there are so many unknowns. Even in the best of situations IVF doesn’t always work. We don’t know which category you will fall into and patients find this unpredictability frustrating. Ultimately, you will need to set goals for yourself and continue to evaluate what will work best for you as your treatment evolves.
Repeat IVF attempts should be considered for patients who do reasonably well with prior cycles. As a physician assistant and IVF case manager, I have seen many patients who want to keep trying who did not respond well to the treatment with the first or second attempts. Unfortunately, IVF does not work for everyone, and you need to be prepared for stopping treatment when the time comes. Your doctor should tell you when they think future cycles will be unsuccessful. It will surely be disappointing but your physician can discuss alternative options with you.
This certainly gives new meaning to the proverb, “If at first you don’t succeed, try, try again.” I wish you all the best of luck in the New Year.
Suzanne Yahiro-Leibowitz has worked in the field of infertility for over 10 years. She is currently a physician assistant and IVF case manager for Reproductive Science Center of the Bay Area. Yahiro-Leibowitz is married and mother to three children.