How Many IVF Cycles are Recommended?

Considering the emotional and physical hardships that occur with failed IVF attempts, it is reasonable to wonder how many attempts one should pursue.  There are also financial considerations, and even travel concerns that can come into play as well.

A study in the New England Journal of Medicine compared live birth rates across 6,000+ patients.  The study found that the highest potential for a live birth occurred at the 6th IVF cycle.  This was true for both age segments - above and below 35 years of age.
One distinct pattern that appeared was the probably for success nearly doubled from the first attempt to the third attempt (33% to 67% in >35 years old).  In fact, the first and second IVF cycles were provided the lowest probability for success - 33% for 1st cycle and 52% for 2nd cycle in >35 years old.  Age played an obvious role in success, with those patients under the age of 35 being twice as likely to give birth as compared to patients over the age of 40.

With this data in mind, prospective parents should consider no less than 3 IVF cycles before looking towards other options.  This of course is assuming all of the research gathered from the first attempts show promise.  If it is learned that egg and embryo quality is poor, then very often it is not practical to attempt another cycle.

So for patients who respond well to ovarian stimulation and produce healthy embryos, there is encouraging data that shows live birth rates should continue to increase through 5 or 6 cycles.  Considering that the average couple discontinues in vitro therapy after 4 unsuccessful attempts, many are opting not to pursue the final high-potential cycles.

Of course all of the research in the world cannot account for the complexities of each case.  There are stories of parents who gave birth on their 11th attempt, and yet there are couples who never realize success after several cycles.  The most important determining factor when considering how many IVF cycles to pursue comes from the data of the first attempt.  This is where your Doctor can advise you on the best scenarios that lie ahead.