Medical Research

When One IVF Cycle Completes All Your Family Building Goals

Most Americans think two children is the ideal number to complete a family, so it’s no surprise that many fertility patients hope that IVF can deliver all the children we want in a single retrieval cycle. In this month's Fertility and Sterility, the team from Boston IVF estimated that nearly a quarter of patients are “one-and-done” candidates – they’ll have two pregnancies and live births from one IVF egg retrieval. Those most likely to qualify are younger, healthier, and produced more eggs in the first cycle.

The group looked at approximately 2,000 patients who had completed an egg retrieval and then used only those fresh or frozen embryos. Since a fair number of patients had not yet returned back to use their frozen embryos, the Boston IVF group had to make a few assumptions on future rates of use and success.

The group determined about 22% of patients were likely to have two or more children from the eggs retrieved in that first cycle. A key determinant was the number of eggs retrieved. Below are actual success rates by the number of eggs retrieved. This doesn’t contemplate those patients with stored embryos who could still return to use them and that’s why the numbers below don’t average out to the 22% figure.

The number of eggs a woman produces is a function of her own underlying fertility and the hormone regimen she is proscribed. On the first count, younger women and those with a lower Body Mass Index were far more likely to produce more eggs and ultimately be “one-and-done” candidates.

When it comes to treatment regimen, clinicians can clearly push the dosage of hormones to yield more eggs. The risk is the doctor overstimulates the woman’s ovaries and dramatically raises her risk of OHSS. For instance, when a woman produces 16 – 20 eggs she is four-times more likely to develop OHSS than a similar woman who produces 6 – 10 eggs. Study investigators were quick to point out that 2% of patients developed OHSS and only 3 of those were hospitalized .

The results of the study are intriguing because for a non-insignificant minority, they had the chance to complete their family goals without absorbing the additional medical, financial and emotional trauma associated with future retrieval cycles. That said, the study has its limitations in that it was conducted at a single center, so it may not be generalizable, and was short enough in duration to require a prediction model to compensate for the fact many patients hadn’t yet returned to use their extras embryos.

Expert's Perspective
Dr de Ziegler's Guide To Endometriosis

Dr. de Ziegler breaks down the misconceptions around surgery being the only way to diagnose endometriosis, weighs in on the decision between IVF and endometriosis surgery, and much more.

Expert's Perspective
When Is The ERA Test Appropriate?

The Endometrial Receptivity Assay is a test used by clinicians to discern when an embryo should be transferred to the uterus. The developmental state of the embryo and the uterine lining must be in sync for the embryo to implant. Here we look at the theory behind the ERA's usefulness and what the data implies about who, if anyone, should have the test performed.

Expert's Perspective
Treating East Asian Women For Infertility

East Asian women may metabolize estorgen differently and this may be the reason their rates of success tend to lag those of Caucasian women. This may add insight on the woman's choice of a fresh versus frozen transfer or how much gonadatropins to take.

Expert's Perspective
How We Might Treat South Asian Women Differently

As a field we're beginning to appreciate that women of different ethnicities may require unique treatment to achieve comparable outcomes. Here, Stanford professor Val Baker eluciates some of the nuances in treating women of a South Asian background.

Expert's Perspective
How Long Are Frozen Eggs and Embryos Good For?

IVF treatment is a relatively new treatment, and egg and embryo freezing are newer still. So do we know how long these gametes can be safely stored and still work?

Expert's Perspective
The Male Fertility Evaluation: Enhances Options and Signals of Future Health

20 - 25% of U.S. couples annually undergo IVF without having the male partner properly checked. This drives tens of thousands of unnecssary treatments, as well as needless cost and suffering. What's more, bypassing this crucial step causes us to miss a vital signal into that man's future health.

Expert's Perspective
Is it safe to ship cryopreserved eggs (and embryos)?

Patients are increasingly eager to ship their eggs and embryos to clinics out of town, out of state and out of the country. Vitrification has made that a far more delicate process. Peter Nagy, Ph.D helps explain the outcomes, steps and costs associated with shipping gametes from one clinic to another.

Expert's Perspective
Freeze Eggs or Embryos?

When the option to freeze embryos is available to patients, many disregard the option to freeze eggs. Owen Davis, ASRM President, weighs in on why egg freezing is still an important option to consider.

Expert's Perspective
From MacBooks to MAC Cosmetics: How Our Daily Routine Impacts Fertility

Dr. Cooper lays out the evidence on the products & habits that harm fertility, and realistic steps we can take to protect ourselves

Expert's Perspective
Improving IVF Success Rates: Using Low Oxygen in the Lab

Selecting a clinic is as much about selecting their laboratory as anything else. A key determinant of lab quality is the conditions they use to culture embryos. Using low oxygen in the incubator is preferable, yet a third of laboratories don't do this.

Expert's Perspective
Early Pregnancy Loss

Early pregnancy loss is the only focus of the team at Montefiore-Einstein in NYC. Here are some of their high-level observations on how to deal with the medical challenges.

+ Show More Articles
Personal Story
Why I Didn't Choose Reproductive Immunology After Miscarriage

After undergoing IVF for secondary infertility, Elissa was blindsided by a miscarriage of a PGS-tested normal embryo. She kept reading online about immunological causes and treatments, so she used her background in reporting to get to the bottom of the treatments behind the chatroom hype.

Personal Story
What We Never Expected About Reciprocal IVF

Christina and her wife Katie decided to bulid their family using Reciprocal IVF. Christina walks us through what turned out how they expected, and what didn't -- including the financial costs, choosing sperm donors, IVF success (and failure), recognition by the state, and having the outside world accept them as equal mothers.

Personal Story
Getting it Together After the Diagnosis: Making a Plan With Your Partner

Laura and her wife Sam always presumed they would need treatment to have a child, but the news Laura had fertility issues came as a surprise. Over the course of multiple cycles, and multiple years, they learned a number of crucial lessons.

Personal Story
Marriage & Male Infertility: Not on the Same Page and That’s O.K.

Men and women often deal differently with the emotional impact of infertility. How important is it for us to see everything the same way?

Personal Story
Twiblings: Being Pregnant During Surrogacy

Some hopeful mothers fear that having a child through surrogacy will be less special or intimate. For those who wonder, meet Nancy Rohde, who carried her own child, and had a baby through surrogacy, at the same time.

Personal Story
Wrangling With Reduction

Many patients undergoing fertility treatment ultimately need to grapple with the notion of whether it is safe to have a multiple pregnancy. Katie Ferraro talks about her decision not to selectively reduce during her quadruplet pregnancy.

+ Show More Articles
Medical Research
What Mosaicism Means for Live Birth Rates

New data compare results transferring different types of mosaic embryos, with surprising outcomes.

Medical Research
IUI Success Rates Doubled With Endometrial Scratch

Medicated IUI success rates remain stubbornly low with live birth rates often around 10% per cycle. Investigators determined whether incorporating endometrial scratch bolsters IUI success rates. For the moment, it appears so.

Medical Research
The Impact of Sugar, Soda and Caffeine on IVF

The team at Brigham & Women's Hospital in Boston reveals surprising results on how sugar, soda and caffeine each impact (or don't) oocyte numbers and ultimate IVF success rates.

Medical Research
CRISPR, Gene Editing and IVF

Gene-editing in IVF made a big breakthrough this month and the CRISPR technology is now a reality. Here we catch up with Paula Amato and the team from Oregon Heath Sciences behind latest breakthrough.

Medical Research
The best starting point in treating PCOS? It’s not Clomid.

PCOS is responsible for 80% of cases where a woman isn't ovulting. A new study compared pregnancy success of clomiphene citrate (clomid) vs. letrozole (femara), with some strong results.

Medical Research
Weight Loss and IVF

The average American woman has a BMI in the high 20's. So for women undergoing IVF, with a BMI in the low-mid 30's, does weight loss improve rates of success? A team from Sweden ran a thoughtfully-conducted trial that offers up surprisingly complex answers.

Medical Research
IUI or IVF For Unexplained Infertility

Roughly 30% of infertility cases are labeled "unexplained," so how should patients decide between IUI vs IVF when we don't know the underlying issue? Here's one clue for a narrow subset of the newly-diagnosed "unexplained" population.

Medical Research
Does Your Clinic Influence If Your Embryos Are Good

Theoretically, the quality of your eggs and sperm should determine the quality of your embryos. However, this month we're reviewing data that shows which clinic you go to, and how they care for you and your embryos, could be a crucial determinant.

Medical Research
When IVF Babies Grow Up, Are They Healthy?

An Israeli study rigorously followed up with adults who were conceived via IVF, and compared their cognitive function, medical and mental health with naturally conceived peers. This is a unique study focusing on the long-term health of IVF babies and adults.

Medical Research
Why It Matters Which Doctor Performs Your IVF Transfer

According to FertilityIQ data, 70% of patients have a different doctor perform their transfer. Scott Morin and Eric Forman of RMA New Jersey study to what extent that matters.

+ Show More Articles