SUCCESS RATE IN IVF (IVF) – HOW TO UNDERSTAND IT CORRECTLY?

Expert advisor: Doctor CKII Du Huynh Hong Ngoc – Head of IVF Infertility Department Phuong Chau

The journey to find a child begins when the couple goes to an Infertility center for examination and consultation, followed by thinking about the cost of treatment (*), then choosing a place where the couple puts their trust. “will have children” when determined to pursue treatment. At this stage, the question is “Which center has a high success rate?” Why does each place have a different number? Why is it so difficult to understand?

To explain this question, IVF Phuong Chau will analyze it specifically so that couples can understand better.

The success of the in vitro fertilization process is having a baby take home. However, pregnancy lasts 40 weeks, so there will be many problems that occur during that journey, including personal problems such as falls, exposure to toxic chemicals, and acute illness. Each person’s personality and constitution, such as short cervix, cervical insufficiency leading to premature birth, fetal abnormalities… these factors will lead to early miscarriage and premature birth of the baby.

For the above reasons, couples do not have a “baby to take home” and these problems are not due to the failure of the IVF treatment center. Therefore, to evaluate the effectiveness of an IVF treatment center, there are the following 4 indicators.

This is the earliest indicator of pregnancy status. Test for beta HCG (a hormone secreted by placental cells). If this index is high, it means that the embryo after being transferred to the uterus is developing. Ultrasound can be detected at this stage, but because the gestational sac is very small at this stage, it is difficult to accurately determine whether the gestational sac is real or fake. This rate ranges from 10-70%, the level of this fluctuation is influenced by the following factors:

+ Age: under 30 years old, pregnancy rate is usually >60%, over 35 years old, pregnancy rate is #40 – 50%, over 40 years old, pregnancy rate is #30%

+ Wife’s medical condition: endocrine diseases such as: Diabetes, Hypertension, Thyroid all reduce the ability to get pregnant. Uterine diseases such as Endometriosis, uterine polyps, uterine deformities, obesity… can reduce pregnancy rates and increase the risk of miscarriage.

+ Embryo quality: Type I embryos (good) have a conception rate of 60 – 75%, Type II embryos (good average) have a rate of # 40 – 60%, Type III embryos (bad, poor) have a rate of less than 30%. %. These rates will increase or decrease depending on the “age” of the embryo, for example, whether the embryo is cultured for 2 days, 3 days or 5 days. How many days it takes to raise embryos will depend on the quantity and quality of each person’s available eggs.

An ultrasound shows the gestational sac in the uterus. According to the policy of each place, the 6 or 7 week gestational age milestone will be used for ultrasound. If the gestational sac is seen and there is fetal heart activity, the conclusion is that the pregnancy is real. The clinical pregnancy rate will be lower than the pregnancy rate using the beta HCG test because there are cases where the test results in pregnancy, then the pregnancy stops growing, ectopic pregnancy or early miscarriage so the ultrasound cannot be seen. gestational sac in the uterus. The clinical pregnancy rate ranges from 40-60%, this rate is affected by the wife’s age, embryo transfer status and the wife’s constitution, so it will vary from person to person.

Is the rate of pregnancy, ultrasound shows the fetal heart and monitors the fetus after 12 weeks and the fetus develops normally. This rate will be lower than the clinical pregnancy rate because there are cases where ultrasound shows a viable gestational sac and then the fetus is stillborn or has a miscarriage due to chromosomal abnormalities or accidents or acute illnesses.

Evaluate pregnancy and live birth. This is a rate that accurately reflects the effectiveness of IVF treatment. However, this index is affected by age, pregnancy, each person’s constitution (especially weight gain and obesity) and medical conditions acquired during pregnancy. Therefore, this rate ranges from 20-50%. It is a fact that the number of people who get pregnant after embryo transfer and nursing until giving birth to a healthy baby is reduced by half.

Through analyzing the above indicators, it can be seen that an IVF treatment cycle depends on many factors such as: age (under 30 years old always has a high success rate of 60-75%, after 40 years old the success rate is high). low success rate #10-30%), uterine structure, health status of the pregnant woman, current weight (Obesity is a high risk, affecting the quantity – quality of eggs, embryos and health. high rates of miscarriage and premature birth).

Each couple will have a different number of embryos, quality of embryos and age of the embryos, leading to different success rates. During pregnancy, there is currently no method that can guarantee 100% safety, so there will be unwanted situations leading to stillbirth, miscarriage, fetal malformations requiring termination of pregnancy, premature birth, and congenital heart disease. baby’s birth after birth. Because of these many risks, the live birth rate is often lower than the pregnancy rate after embryo transfer. Each couple will have a different “chance of getting pregnant” so it is not possible to take one person’s rate and apply it to another.

Expert advice is that when couples need In Vitro Fertilization treatment, they should seek clear information. There are two very important things: How much does it cost? (Refer to the doctor’s article for details at the link: (https://phuongchau.com/giai-oan-cho-chi-phi-dieu-tri-thu-tinh-trong-ong-nghiem-moi-noi -mot-gia-1903) and what is the couple’s success rate? Therefore, each couple will have a different pregnancy rate depending on their medical condition, age, and pregnancy history. before, living habits…all these factors affect the success rate. More importantly, each index provided by IVF centers to couples should be checked by a third party evidence because this is an important indicator to help couples decide on treatment.

Currently, there is an organization in the world that specializes in evaluating the quality of treatment of in vitro fertilization centers around the world, which is the Reproductive Technology Accreditation Committee (RTAC) of the United Nations Association of Reproductive Technology (RTAC). Australian and New Zealand Fertility Society. This is the agency that has developed and issued a set of practice standards in assisted reproductive treatment, helping treatment centers maintain and always improve the quality and effectiveness of treatment. To be recognized by this Committee as meeting their practice standards, fertility centers need to provide evidence demonstrating their ability to provide SAFE, EFFECTIVE, and GUARANTEED SUCCESS RATE treatment. This evidence will be examined, verified and reported to the RTAC Committee by an independent agency. Accordingly, IVF Phuong Chau has been evaluated, appraised, and granted a license to be recognized as a Reproductive Support Center meeting RTAC international standards. By achieving RTAC certification, it helps couples have reliable information about data, helps manage pregnancy more safely, and reduces the risk of miscarriage and premature birth.

(*) (https://phuongchau.com/giai-oan-cho-chi-phi-dieu-tri-thu-tinh-trong-ong-nghiem-moi-noi-mot-gia-1903)

Reference source:

Data at IVF Phuong Chau
Boucret, Lisa, et al. “Endometriosis lowers the cumulative live birth rates in IVF by decreasing the number of embryos but not their quality.” Journal of Clinical Medicine 9.8 (2020): 2478.`
Chen, Di, et al. “Cumulative live birth rates for low-prognosis women over 5 years or 9 frozen-thawed embryo transfer cycles.” BMC Pregnancy and Childbirth 22.1 (2022): 1-12.
Gleicher, Norbert, Vitaly A. Kushnir, and David H. Barad. “Worldwide decline of IVF birth rates and its probable causes.” Human Reproduction Open 2019.3 (2019): hoz017.
Nargund, Geeta, and Adrija Kumar Datta. “Maximizing live birth rates cannot be the only key performance indicator of IVF.” Reproductive BioMedicine Online 44.4 (2022): 587-589.
Sermondade, Nathalie, et al. “Female obesity is negatively associated with live birth rate following IVF: a systematic review and meta-analysis.” Human reproduction update April 25 (2019): 439-451.

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