ART Pregnancy Rates
The following tables show the chances of success at ART for various age cohorts for the procedures IVF, ICSI, FET and OI over the 5 year period 2005 to 2009. This period was chosen as sufficient numbers of procedures were available in the chosen age cohorts for pregnancy outcomes to be reliable. Please note if there are less than 50 procedures in a cohort we have been advised that the outcome for that cohort is not statistically reliable.
The live birth rate is significantly lower than the pregnancy rate because up to 30% of pregnancies do not result in a live birth due to early pregnancy loss or miscarriage. Therefore when comparing success rates for assisted reproduction it is important to compare live birth rates with live birth rates, not with pregnancy rates.
The live birth rate for assisted reproductive technologies is typically measured as a percentage of live births per embryo transfer for IVF, ICSI and FET, and is measured as live births per commenced cycle for Ovulation Induction, OI. The following information shows the live birth rates for these treatments achieved at Canberra Fertility Centre between 2005 and 2009 for the different female patient age ranges shown. As the pregnancy rate is based upon live births, those pregnancies that did not result in a live birth, for instance due to early pregnancy loss, are not counted although they are included in the number of commenced cycles or transfers.
The numerical data is below each graph to show the number of treatments the pregnancy rate is based upon. Obviously, the greater the number of transfers in a particular age range for IVF/ICSI/FET, or the greater the number of commenced cycles for OI, the more reliable the live birth rate is due to less influence of individual variation on the results. However, regardless of the number of cycles or transfers per age range, each patient should be aware that her individual circumstances may cause her success rate to differ from that shown for her age and treatment type. For instance, a live birth rate of 20% does not mean that after 5 cycles every patient can expect a live birth.
The major factor affecting the live birth rate shown in the graphs below is the influence of age. For all treatment types, the pregnancy rate for patients over 40 years is considerably less than for patients 31 years and below. In particular, the live birth rates for patients over 42 years are often markedly reduced.
The key message is the poor outcome once a woman reaches the age of 42. This 5 year series shows no IVF live births and in 25 years of operation Canberra Fertility Centre has only had 2 IVF live births in women who were older than 42 at the time of conception.
As expected ICSI shows strong success in the younger age bracket, however this is unlikely to be a function of the technique itself. Patients in this group are there due to male infertility and these results support ICSI’s ability to treat male infertility successfully.
The dotted line shows the average live births obtained Australia wide. Again the key message is the very poor outcome for women aged 42 or greater. The other key message is that average success remains around 20% or 1 in 5 transfers leading to a live birth.
A key message is that frozen embryo transfer is far more successful that it is perhaps given credit for, with a live birth outcome 70% of that of a fresh transfer. Therefore on average an embryo only loses 30% of its viability on freezing.
In the past the focus has been on the more sophisticated treatments such as IVF. OI can be thought of as the quiet achiever. It is vastly cheaper and a less invasive treatment and for older patients live birth success is on par with IVF and has the opportunity of more treatments per unit of time. Over the years we have achieved pregnancy rates for OI of between 10 and 20% depending upon the age bracket and the cumulative pregnancy rate for OI cycles is approximately 70% after 10 treatment cycles.
Insemination
Over the years the Canberra Fertility Centre has averaged a rate of 9.7% per cycle of treatment. This compares favourably with figures quoted by other major units of between 8 and 10% and cumulative rates of 30-60% after 6 treatment cycles.