When a couple is about to face an MAP treatment, they will surely have many questions in mind, one above all: “How many cycles of assisted fertilization do you need to be able to get pregnant?”. The desire to succeed at the first attempt is very much but, statistics in hand, the data that are often repeated is that an IVF fails in 70% of cases. An IUI in about 90%.
These are numbers that at first glance can be frightening. Apart from rare exceptions, when you decide to undertake a path of MAP you have to take into account (in all senses) more than one treatment to increase the chances of obtaining the desired result.
There are various factors that intervene in the success or failure of the treatment: the problem that requires the couple to resort to assisted fertilization, the age (in particular of the woman), whether or not to resort to the donation of gametes. Without forgetting the quality / experience of the center to which the couple turns.
in conclusion all these factors do not allow to make precise estimates.
Certainly great strides have been made since 1978, when Luise Brown was born, the first child born thanks to in vitro fertilization.
Since that time, the history of reproductive medicine has been radically turned upside down. Luise’s birth was the beginning of a new way of becoming a family.
Nowadays, in vitro fertilization (IVF) is a much more advanced and common procedure. According to the US CDC in 2018, in vitro fertilization resulted in 73,831 successful pregnancies in the US and a total of 81,478 live births.
In Italy, the National Register of PMA has currently published the data for 2017 which are as follows:
- 78,366 couples treated with first, second and third level medically assisted procreation techniques
- 97,888 treatment cycles initiated
- 18,871 pregnancies obtained
- 12,490 parts obtained
- 13,973 live births representing 3.0% of the total born in Italy in 2017 (458,151 live births, Source: ISTAT)
The number of couples who use MAP is increasing every year, and in part this could be linked to the fact that the average age at which a woman seeks her first child has risen considerably in recent years. We know that a woman’s fertility drops after 35-36 years of age and the higher the average age of seeking the first child, the less likely she is to get pregnant naturally.
In vitro fertilization treatments vary depending on many personal factors: health, age, specific fertility problems …
For example, simplifying, a woman who has closed tubes cannot perform intrauterine insemination but will necessarily have to resort to in vitro fertilization. A couple in which the male has very few spermatozoa will have to resort to ICSI.
In vitro fertilization requires the stimulation of follicular growth, the recovery of mature oocytes from the ovaries (pick-up), in vitro fertilization in the laboratory and finally the transfer of the embryos obtained in the uterus.
Some structures support the transfer of one embryo at a time (an increasingly widespread procedure used to avoid the risk of multiple pregnancies that often lead to complications), while others transfer more embryos (2 or 3) to increase the possibility that at least one embryo will implant. and results in pregnancy.
It is important to remember that, just like natural conception, too in vitro fertilization can take several cycles to be successful.
A 2015 study published in JAMA found that success rates nearly tripled when women continued IVF for over six cycles, going from 20% to 60%.
An intrauterine insemination treatment has a 10% success rate with a cumulative rate of approximately 25% within 6 attempts.
The success of MAP is linked to many factors. The chances may be increased if lifestyle changes are associated with the treatment such as changes in diet, exercise. Some supplement treatments with acupuncture and other alternative medicine techniques, although a 2018 study from Western Sydney University and published in Science Daily gave unsatisfactory results. The study looked at 848 Australian women between the ages of 18 and 42. Some underwent acupuncture and others underwent ‘sham acupuncture’. The researchers found an “insignificant difference” in birth rates between the two groups of women
Will assisted reproduction treatment work?
This is a million dollar question, and no one can answer it with absolute certainty. As IVF procedures increase in accuracy and doctors gain experience, the odds are, of course, better. But it is still a gamble. It is also expensive if it is addressed in private centers.
Although the percentages vary, couples who receive IVF treatments have about a 20% to 30% birth rate, not much different from the success rate of those who conceive without medical assistance. The study published in JAMA concluded that the live birth rate for the first cycle is 29.5%. This success rate remained above 20 percent until and including the fourth cycle.
Some additional considerations
In vitro fertilization has risks, just like any invasive medical procedure. Stress, ectopic pregnancies, and multiple births are just some of the possible side effects also listed by Mayo Clinic, and while they are not common, they are worth considering carefully before moving on.
Sites like Periodofertile with its forum dedicated to MAP and social media are a great place to find other families who are going through a similar journey.
They are virtual places where women share their stories and support each other. If you choose to embark on this journey, these groups can be an important source of support along the way that may prove more complicated than expected.