Persistence pays with IVF

In vitro fertilisation (IVF) is, without doubt, a harrowing experience for even the most determined-to-get-pregnant couples.

There are tough physical processes like hormone injections, egg retrieval, embryo transfer and more. But more difficult than these physical aspects of the process is probably the emotional toll it can take on a couple, especially after one or two unsuccessful rounds.

And at some point, if several rounds of IVF have not resulted in a pregnancy, another tough decision couples must grapple with is when to call it quits.

In fact, doctors generally assume the chances of pregnancy are low after three to four rounds of IVF.

But now, a new study is proving otherwise.

Hope for couples going through IVF

A large study published recently in The Journal of the American Medical Association (JAMA) has found that nearly two-thirds of women going through IVF will get pregnant by the sixth attempt.

And "the cumulative rate for live births continues to increase, albeit modestly, up to the ninth cycle of IVF", says a New York Times report.

Read about the study on the next page. 

The study

The study involved nearly 157,000 British women who together underwent more than 257,000 cycles of IVF treatment between 2003 and 2010.

Reportedly, "the rate of live births for participants after the first cycle in the new study was 29.5 percent, compared with 20.5 percent after the fourth cycle, 17.4 percent after the sixth cycle, and 15.7 percent after the ninth cycle."

Dr. Evan R. Myers, a researcher and a professor of obstetrics and gynecology at the Duke University Medical Center, says “Instead of saying, ‘If you haven’t been successful after three or four cycles, think about donor eggs or adoption,’ the study says, ‘If you keep going, there’s still a substantial chance.’ ”

Also,  some medical professionals believe that women who produce just two or fewer eggs after ovarian stimulation are less likely to become pregnant following consequent IVF cycles. However, the study found no evidence supporting this belief.

“We found that just isn’t the case,” said Dr. Debbie A. Lawlor, an epidemiologist at the University of Bristol and the study’s senior author. “Don’t give a load of importance to any one cycle.”

However, a woman’s age did make a big difference in the outcome, with the live birthrate among women younger than 40 after the first cycle being 32.3 percent, and after the sixth cycle, 17 percent.

Among women ages 40 to 42, just 12.3 percent were successful after the first cycle, and only 6.9 percent after the sixth.

As encouraging as this news is to couples going through IVF, there also is the cost factor -- IVF is not cheap.

In Singapore, since August 2008, the Government has subsidised a maximum of $3,000 per cycle of IVF and ICSI treatment, with up to three cycles per eligible patient.

However, once those three cycles are up, IVF can cost between $8,000 and $11,000 at public hospitals, while it can go up to $15,000 at private centres, according to SingHealth.

Also, the medical risks over doing many cycles must also be taken into consideration, including ovarian hyperstimulation syndrome, a condition in which ovaries become enlarged and fluid builds up in the abdomen.

Still, the news is certainly encouraging for couples trying to conceive via IVF.

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