Have you had an unsuccessful IVF attempt? What next? Juliya Voznesenskaya, MD, Gynaecologist, Reproductologist and Head of Clinic of reproductive and prenatal medicine at European Medical Centre in Moscow, Russia, answered patients’ questions during the Online Patient Meeting. Watch the recording.
In general, the probability of pregnancy in a young woman at 22-26 years is around 20-25 % per cycle and as the age increases, the probability of pregnancy decreases. After the age of 38, it drastically decreases. Therefore, a couple needs time to reach the pregnancy and it is called cumulative probability of pregnancy. That is why it is recommended for the couple to try to conceive naturally for at least for 6, 12 months, before any investigation is done.
Another thing that is important to remember is the probability of miscarriage, which gradually increasing with advancing age. For example, a 42-year-old woman has around 5% of achieving a pregnancy, but the chance of miscarriage is about 35-40%. Even if it is IVF program, the numbers are similar. When we’re talking about IVF, there is one more additional indicator, the number of eggs that will be retrieved. Even in young women with only 4-5 eggs, the probability of achieving a pregnancy is quite high, it’s around 30%. In older women, even though we have 10-15 eggs, which is a lot, the chance of pregnancy is low. Therefore, understanding the chances is crucial for the doctors and patients who want to embark on IVF journey.
There are some crucial steps that need to be considered before starting IVF treatment. The first is preparing for the treatment, the patients need to be diagnosed and thoroughly investigated. The second matter is IVF protocol management. It is important to check how the stimulation is going, what kind of medication is used, what is the correct dose, what kind of trigger should be done for this patient. All previous protocols or attempts should be investigated as well and if something was wrong, some additional tests may be required. Another significant aspect is embryo quality and embryo transfer. It’s crucial to know which embryo will be best to transfer and if the embryo transfer has been performed before, if all was okay or there were some difficulties.