Experiencing parenthood is the most desirable wish to come true for any couple who has long planned to conceive. There is tremendous pressure from society and family and it also involves a great deal of psychological and financial trauma for those who have failed despite repeated attempts.
In vitro fertilization (IVF) is a boon for many of those people who cannot conceive with conventional infertility treatments. While successful IVF cycles have fulfilled the dreams of many, a failed cycle can also have devastating effects, especially in an Indian context where economic conditions and social pressures play a critical role in the treatment decision. In relation to this, a crucial question arises, that is, the number of IVF cycles required for a successful pregnancy, in the mind of every couple who visits a clinic due to its varied results and the cost involved. Although important, the answer can never be an absolute number, as IVF is an individualized treatment program.
Successful IVF cycles depend on several factors:
- Age: the most important factor and is not modifiable. As the female age increases, the quality and quantity of the oocytes changes, which indirectly affects the quality of the embryo.
- Cause of infertility:
A. Tubal factor (bilateral tubal block, hydrosalpinx): good results
B. PCOD (polycystic ovarian disease): it is a hormonal disorder and, depending on the severity, varied results are observed. For mild to moderate PCOS without any other factors, good results can be expected.
C. Causes of the endometrium (thin endometrium, infection): – cautious results if the endometrium does not respond.
D. Uterine factor: Depending on the condition (polyp, fibroma, anatomical factors) varied results are observed,
E. Oocyte Quality: In women over the age of 35, the quality of the oocytes decreases, affecting the results. Egg donor program has increased success rates
F. Male factor: Mild to moderate abnormalities have good results, while severe abnormalities require the use of advanced techniques such as ICSI (intracytoplasmic sperm injection), IMSI (morphologically selected intracytoplasmic sperm injection) for good embryos to form.
- Advanced IVF Center with Fully Equipped Laboratory – Best results always require competent doctors, embryologists, and an advanced laboratory for good embryos to form.
- Medical illness: the presence of morbid obesity, diabetes, hypertension, tuberculosis, addictions such as smoking and alcohol, can affect the results if they are not under control.
Among the above, the miracle factor is AGE. The younger the woman, the better the prognosis on the first try. Women under the age of 35 have a higher success rate compared to women with an older age group. But in such an advanced age group, egg donor IVF has a much better prognosis and higher success rates.
Successful IVF cycles in all age groups in this modern era are attributed to the use of several new available technologies, such as:
- Blastocyst or embryo transfer on day 5: Compared to embryo transfer on day 2 or 3, where success rates are around 30 to 35%, the results of embryo transfer on day 5 are more twice as much due to better embryo selection.
- Assisted Hatching Techniques: Helps thin the embryo cover, resulting in higher implantation rates.
- ICSI: In severe male factor abnormalities, ICSI aids in better sperm selection and fertilization.
- Immunotherapy: Highly beneficial for women with immunological abnormality.
- PGT: Genetic embryo testing, particularly in older women, can help screen for euploid embryos.
Therefore, accurate diagnosis of the cause of infertility and appropriate guidance from clinicians for the best possible treatment can reduce treatment at the time of pregnancy. The couple should be adequately counseled about infertility problems, with a thorough understanding of the success involved and the various treatment options available.
Indian data on the average number of cycles required in a particular age group is lacking, while Western countries have reported an average of 2 to 3 cycles in any age group. As demographic conditions vary between continents, such results cannot be extrapolated to the whole world.
Therefore, the only way to achieve success is to target the right time and age to show up and use advanced treatment facilities. The common man should be aware of the various treatment options available. Also, to reduce the chances of success, one must take care of the general health, have complete control of the medical problems, have a deep knowledge of all the possible causes of those problems and the availability of specific treatment facilities.