Among the various questions that arises in a couple’s mind before starting an ART program, the most recurrent and most concerning one is the outcome of the procedure.
In other words, what are the chances of a woman conceiving after undergoing an ART treatment?
In normal situation, the chances of a young and fertile couple to conceive naturally, with all the parameters being normal itself is only 20% per cycle. The same scenario can be extrapolated to ART procedures. However, with the advent of advanced techniques, the success rates in an ART program have improved to 50%. The Success rate that we refer here to is the woman becoming pregnant (otherwise called as clinical pregnancy).
It is also important to understand that the success of an ART procedure depends on number of factors including the training and experience of the Embryologists and the medical and scientific expertise available in the ART clinic.
There are many other aspects that also play a crucial role in a successful pregnancies. Key factors include age, BMI, the quality of their gametes (sperm & oocyte), genetic factors, stress etc. that determine the outcome of an ART program.
Assuming the above are fairly in-line with expectations, implantation (a process by which the embryo attaches to the uterine lining called the endometrium and continues its growth into a fetus) is still a mystery. Even with the most advanced techniques and a good blastocyst being transferred, there still is a chance of the cycle failing due to failure of implantation. In this context, no clinician or fertility unit can assure the success of an ART cycle.
This process is highly complex and mainly requires a good competent day 5 embryo, called the blastocyst and a receptive endometrium for it to interact with and is influenced by various factors including genetic and immunological factors. Also, research in the field of implantation is still primitive and the mystery behind the same remains to be unravelled fully. However, couples need not despair if they remain open for accepting sperm, egg or embryos from a donor.
For a better understanding of the success rates worldwide, here are some references:
1. According to reports published by the America’s leading ART watchdog, Society for Assisted Reproductive Technologies (SART), off the 92,862 fresh ART cycles done in the year 2014, 30,647 (33%) led to a pregnancy, but only 25,016 (27%) resulted in a live birth. http://www.sart.org/SART_Success_Rates/
2. The human fertilization and embryology authority (HFEA), UK, reports that in the year 2014, of 67,708 cycles of IVF or ICSI, pregnancy rate (per embryo transfer) for patients receiving IVF treatment using their own fresh eggs, is 36.3% http://www.hfea.gov.uk/ivf-success-rate.html
3. According to the Australian & New Zealand Assisted Reproduction 2014 Database (ANZARD), of the 73,598 ART treatment cycles in 2014. 23.7% (17,427) resulted in a clinical pregnancy and 18.2% (13,373) in a live delivery.https://npesu.unsw.edu.au/surveillance/assisted-reproductive-technology-australia-and-new-zealand-2014
Success rates vary between IVF centres because, the patient characteristics, treatment approaches and technical expertise vary from clinic to clinic. Therefore, it is not meaningful to compare success rates of a clinic with another and couples should also take into consideration the various factors which leads to the success of an ART cycle before assuming their chances of success with treatment. It is also impractical to expect 100% success rates in ART due to the reasons mentioned earlier.
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