The average success rate of IVF for a woman under 35 years of age is 40 percent. Given those odds, I wasn’t shocked when our first IVF embryo transfer failed. But after four failed transfers of five highly-graded embryos, I can’t help but feel completely discouraged and suspect of this entire process. Exactly how many IVF cycles does one need to undergo before she achieves success?
According to this 2015 study published in the Journal of the American Medical Assn., it’s way more than you might expect! Before you start thinking about throwing in the towel and quitting your IVF journey, read this important information below.
When to Give Up on IVF Treatment: What’s the Magic Number?
The U.K. based study, which analyzed over 250,000 in vitro fertilization attempts by more than 150,000 women for nearly a decade, revealed 3 key findings:
- Women abandon IVF too soon – typically after three or four unsuccessful attempts.
- If women continue with IVF they have a 69% chance of having a baby after nine IVF cycles.
- Moreover, the majority of women – 65.3% of patients in the study – achieved success after just six cycles of IVF, particularly if they were under the age of 40.
- On average, the process of success for IVF (i.e. six to nine cycles) will take a total of two years, which is similar to rates that couples conceiving naturally take in one year.
While doing six to nine IVF cycles over a period of two years may still seem outlandish to some, I have to admit that these findings made me feel exceptionally better. Particularly, because they also support the general trend that I’ve found among my friends whom have struggled with getting pregnant via IVF, which is namely: it takes a few fails before one “sticks.”
Indeed, one of the best pieces of advice I’ve ever received during this journey was from a friend who is currently pregnant with her second IVF conceived baby after struggling with multiple failures for many years. Over a recent dinner with a group of friends she discreetly pulled me aside and whispered: “You will get pregnant, I’m sure of it. The secret is you just have to stick with it.”
Her calm assuredness was absolute magic to my ears. Suddenly, the question of our success was no longer “how?” but “when?”. It was everything I needed to hear.
Repeat Implantation Failure – An Outdated Definition
The medical definition of recurrent implantation failure is “failure to achieve a clinical pregnancy after transfer of at least four good-quality embryos in a minimum of three fresh or frozen cycles in a woman under the age of 40 years.” Clinically, I fall into this dismal definition. Clinically, I’m part of the 10% of women who face what the definition calls a “frustrating and distressing” diagnosis. But something about that never felt right. When I referenced the term “recurrent implantation failure” to Dr. M., she rolled her eyes. “That’s an outdated and very conservative definition,” she explained. And according to the above study, she’s right. The LA Times summarizes:
“The conventional wisdom in assisted reproduction circles is that women who do not have a baby after three embryo transfers suffer “repeat implantation failure,” the study authors wrote. Also, doctors continue to be guided by an outdated study that said live birth rates decline after four IVF cycles. Together, these have prompted many women to abandon fertility treatment after three or four unsuccessful embryo transfers.”
While the diagnosis of “recurrent implantation failure” shouldn’t be discarded all together (believe me, it’s alive and well over here!), its rigid and somewhat outdated definition of “three to four cycles” shouldn’t discourage couples from moving forward with IVF treatment that exceeds its bounds.
Conclusion: How Many IVF Cycles Should You Try Before Stopping
The one factor that the study doesn’t analyze is cost – which to most people who undergo IVF is the number one deciding factor of moving forward with yet another cycle. The absence of a cost analysis solution renders these findings of “charging ahead” with up to nine transfers completely unrealistic for some and downright laughable to most. But as a couple who has decided to stay the course and embark on embryo transfer #5 in just a few weeks, I can’t help but feel emboldened by this study, which further supports my own inherent feelings to just keep going – despite the odds, despite the past failures, despite the pain and exhaustion. While I’m not sure exactly what our magic number will be before we finally decide to bow out of this racket, I do know with complete confidence that we aren’t there yet. Wish us luck on transfer number 5!
hi there! im in the same journey! any success on this cycle?
Did you get there? How many transfers did it take?
So how did it go with round 5? I feel somewhat reassured reading this. We are about to embark on round 6. I don’t feel like I have the energy for it but sonehow trying to find the strength to carry on. I turned 40 last year not sure if it will ever happen. I just can’t imagine my life without a child that we can create ourselves. Hate it when people keep suggesting adoption that’s just not an option for me. I’m also now taking a number of vitamins to help with egg quality. Let’s see if that works.
Curious if you ever learned your lucky number?
Ivf centers are crazy for taking advantage of couples who want children 9 cycles is outlandish. Anything over 3 is unacceptable and they know it.
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4 Cycles – the last one just took way too much of a toll on me physically and mentally. It takes us a year to save up and recover each time. After 5 years it’s just not worth my mental and physical health anymore.
6 cycles and still no baby. I keep miscarrying.
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Thanks for the references – 6-9 cycles is not such a bad outlook after all, if I understand correctly that this means 6-9 embry transfers. It seems that there is some confusion about what an ivf cycle includes. Stimulating the ovaries, possibly dealing with an overstimulation syndrome, retrieving the eggs, having them fertilized, hoping that as many as possible will develop and survive day after day, having them tested for genetic defects, and then having one (or more) transferred is surely a costly undertaking, and on top of that is physically and mentally very exhausting. I hope that it does not take 6-9 complete cycles like this!? After all, each woman after each cycle will have very different numbers of viable embryos (as protocols of how much to stimulate etc. differ widely from place to place). So if after this process, you have more than one embryo frozen, waiting to be transferred, the next embryo transfer is much, much less expensive as well as physically exhausting (the mental toll is definitely a completely differnt story). So 6-9 embryo transfers (meaning ~2 complete stimulatin cycles) seems not too bad.
In my case, I have undergone 1 stimulation cycle so far. Got 13 eggs, of which 8 could be fertilized, of which 5 were still alive after five days – a decent outcome according to our doctor. We had decided to send 4 in for genetic testing, but transfer one embryo right away, so that we would not lose another. Of the 4 that got tested, 1 had many defects – so it was 3 left that were frozen, waiting for a later transfer. The very first embryo (not testet) lead to a pregnancy. First trial – yeah! But I lost it in week 8. It was a missed abortion, meaning it did’t come out (but you see on the unltrasound that the heart had stopped beating and it had stopped growing). After a failed attempt to get it out with medication, I needed to go to the hospital to have a curettage. After my period started again, meaning that my cycle got back to normal, we started attempt number two with one of the three frozen embryos. I just got the blood testing yesterday – the embryo has not implanted. So we have two frozen embryos left. That means that from one complete ivf cycle, I got / will get 4 embro transfers in total. If according to the references here, it takes 6-9 embryo transfers to get pregnant, it is likely that I’ll need another stimulation cycle (or possbly two) in order to get a baby. So let’s see.