The prognosis for patients with a cancelled IVF cycle

Abstract

Objective: To investigate the prognosis for pregnancy after one cancelled IVF cycle. Design: A descriptive retrospective review. Material and Methods: Computerized office records were queried for patients who had a cancelled cycle during 1999 and 2000. A database was created and information was entered on all subsequent attempts of these patients. Pregnancy rate is defined as the presence of fetal heart activity. Results: A total of 162 patients had one IVF cycle cancelled and went on to try again, many more than once. Of 302 subsequent IVF cycles, the overall pregnancy rate was 15.6%, 20.9% in women 40 and under, and 10% in women 41 or older. Of the 162 cancelled patients, 40.8% ultimately became pregnant: 46/142 (32.2%) with IVF and 16/142 (11.3%) with DE. DE represented 5.8% of the pregnancies in women who had a second attempt, but it represented 67% of the pregnancies in those who became pregnant on their 4th or 5th attempt. Twenty patients were cancelled due to elevated FSH and/or estradiol levels on day 3. When success of their next cycle was examined, 7 were cancelled again for elevated day 3 results, 2 were cancelled for cysts on day 3, 2 achieved retrieval but no pregnancy, 1 had an IVF pregnancy and 2 were successful with DE. Conclusions: When informing a patient that her IVF cycle she should be reassured that “all the news is not bad” as an IVF pregnancy after a cancelled cycle is possible. As expected, patients 40 and under fare better than patients over 40. Being cancelled for elevated day 3 hormones is an ominous sign, as the per-start pregnancy rate in the next cycle is only 5.5%. Patients utilize donor eggs increasingly as subsequent IVF attempts fail.