Cumulative success rates following mild IVF in unselected infertile patients: a 3-year, single-centre cohort study

Abstract

A 3-year, retrospective, single-centre cohort study was conducted in a private infertility centre to determine cumulative live birth rates (LBR) per scheduled oocyte retrieval following minimal ovarian stimulation/natural-cycle IVF in unselected infertile patients. A total of 727 consecutive infertile patients were analysed who underwent 2876 (median 4) cycles with scheduled oocyte retrieval from November 2008 to December 2011. Natural-cycle IVF or clomiphene-based minimal ovarian stimulation was coupled with single-embryo transfer and increased use of delayed vitrified–warmed blastocyst transfer. Main outcome measures were crude and expected age-specific cumulative LBR per scheduled oocyte retrieval. Crude cumulative LBR were 65%, 60%, 39%, 15% and 5% in patients aged 26–34, 35–37, 38–40, 41–42 and 43–44years, respectively. No live births occurred in patients aged ⩾45years. Dropout rates per cycle were 13–25%. Success rates gradually reached a plateau, with few additional live births after six cycles. Most of the expected success rate was reached within 6months with almost maximal rates within 15months of the first oocyte retrieval. Acceptable cumulative LBR are reached with an exclusive minimal ovarian stimulation/single-embryo transfer policy especially in patients aged <38years but also in intermediate aged patients (38–40years).A 3-year, retrospective, single-centre cohort study was conducted in a private infertility centre to determine the cumulative delivery rates following minimal ovarian stimulation/natural-cycle IVF in unselected infertile patients. A total of 727 consecutive infertile patients were analysed who underwent 2876 treatment cycles (median four) with scheduled oocyte retrieval from November 2008 to December 2011. Natural-cycle IVF or clomiphene-based minimal ovarian stimulation was coupled with a universal single-embryo transfer policy and increased use of delayed cryopreserved blastocyst transfer. Main outcome measures were crude and expected age-specific cumulative delivery rates. Crude cumulative live birth rates were 65%, 60%, 39%, 15% and 5% in patients aged 26–34, 35–37, 38–40, 41–42 and 43–44years, respectively. No live births occurred in patients aged ⩾45years. Dropout rates per cycle varied between 13% and 25%. A plateau in success rates was reached gradually with few additional live births after six cycles. Most of the expected success rate was reached within 6months, with almost maximal rates within 15months of the first oocyte retrieval. Acceptable cumulative live birth rates are reached with an exclusive minimal ovarian stimulation/single-embryo transfer policy especially in patients aged <38years.