Objective: Much has been written about the cumulative pregnancy rate of consecutive In Vitro Fertilization (IVF) cycles. However, most data sets report a significant number of drop-outs (patients who, as a result of active or passive censoring, discontinue further attempts at pregnancy) and there is disagreement regarding the reproductive potential of these patients. Design: A retrospective chart review of 107 consecutive patients whose first treatment cycle took place between April 1999 and December 2000; and who were offered, at the outset, the opportunity of three transvaginal oocyte retrievals (TVOR) through a shared risk program. Cryopreservation of supernumerary embryos was performed when available, and frozen embryos were utilized prior to proceeding with subsequent TVORs. Donor oocyte cases were excluded from analysis. The selected patients met the following criteria: <35 years at the time of the first TVOR (age criteria selected based upon data showing limited detrimental impact of this variable on implantation rates through age 36 (1)), adequate ovarian reserve, and normal sonographic appearance of the uterine cavity. Cycles were cancelled with fewer than 4 follicles between 12 and 20 mm on the day of HCG. Rate of cycle cancellation during that time period was less than 5%. Materials/Methods: Most ovarian stimulation cycles included down regulation with a GnRH agonist followed by ovarian stimulation with injectable gonadotropins. The ovulatory dose of HCG was administered 36 hours before follicle aspiration, when at least 1 follicle reached a mean diameter of 18mm. All embryo transfers were performed on day 3 after oocyte retrieval, and under transabdominal ultrasound guidance. Only delivered or ongoing pregnancies are reported. Results: See table below:TableThe following table summarizes our experience:CycleNumber of TVORsFresh Preg.FET Preg.Total Preg (%) per TVORDropouts1st10753558 (54)5 (1 preg)2nd4424125 (57)63rd1333 (23)Total16480686 Open table in a new tab Conclusions: We achieved a true cumulative take home pregnancy rate of 80% (86 deliveries or ongoing pregnancies in 107 patients) following up to three cryo-augmented cycles. This experience is consistent with a 72% cumulative delivery rate obtained in a similar group of 100 patients who underwent treatment between 1996 and 1997(2). In both studies, there was a decrease in pregnancy rate at the time of the third IVF cycle in spite of active censoring. The fact that another three pregnancies were achieved in this group outside the scope of this study (spontaneous pregnancies, additional later IVF cycles, Donor Egg IVF), and that many of the patients who never achieved a pregnancy had obvious poor embryo quality, suggests a limited role, if any, for immunologic etiologies for failure to establish a pregnancy. Supported by: 1. Spandorfer SD et al. J Assist Reprod Genet 2000;17:303–6. 2. Stassart, JP, et al. Fertil Steril. 1997; S194.