Assisted fertilization

What are the success rates of an assisted reproduction treatment?

Very often women who have unsuccessfully undergone assisted reproduction treatment write to us asking us why it was not successful. We forwarded the question to our fertility geneticist, Dr. Daniela Zuccarello.

Here is what he explained to us:

The PMA success statistics problem is really complex because the percentages depend on many factors , including:

  • patient age : the younger the woman, the better the full-term pregnancy rates. In general, up to the age of 35 the success rates are around 25% per treatment, after the age of 40 they drop drastically to around 10-15%.
  • concomitant pathologies : uterine factors (anatomical or functional), coagulation anomalies, autoimmune pathologies, endometriosis, systemic pathologies, etc… All these factors decrease the pregnancy rates.
  • fertility status : hormonal measurements (FSH, E2, AMH) and ultrasound of the antral follicles can help to understand the residual ovarian reserve and any response to treatment
  • type of stimulation protocol : the more personalized it is and not “standard”, the better the success rates.
  • timing of the transfer : immediately after stimulation or on a physiological cycle with embryo freezing (the latter gives the highest success rates)
  • embryonic stage : blastocyst transfer (5-6th day of development in vitro) offers a few percentage points more (compared to transferring the embryo on day 3).
  • LAST BUT MOST IMPORTANT OF ALL: pre-implantation diagnosis
    for  numerical chromosome abnormalities. The only method for which it has been demonstrated, with randomized controlled scientific studies, an increase in pregnancy rates, a significant decrease in spontaneous abortions and, above all, a marked improvement in the “time to pregnancy”, i.e. the time it takes to achieve a full-term pregnancy. In other words, if the woman has some good oocytes, sooner or later (even without pre-implantation diagnosis) I will find and transfer them, but making the woman waste precious time and exposing her to risks such as miscarriages.If, on the other hand, I carry out the pre-implantation diagnosis, I immediately find the embryo with a normal chromosome set, i.e. the embryo that has the best chance of implanting itself and reaching the term of pregnancy.

In many centers that carry out PGS (pre-implantation analysis for chromosomal aneuploidies) the percentage of full-term pregnancy after transfer of a single embryo with normal chromosomes reaches 55%.

For the reasons explained above, the PMA success rates must be “personalized” on each individual case , and it is the duty of the center (and of the treating gynecologist) to expose this type of statistics to the couple before starting the cycle.

Kathryn Barlow is an OB/GYN doctor, which is the medical specialty that deals with the care of women's reproductive health, including pregnancy and childbirth.

Obstetricians provide care to women during pregnancy, labor, and delivery, while gynecologists focus on the health of the female reproductive system, including the ovaries, uterus, vagina, and breasts. OB/GYN doctors are trained to provide medical and surgical care for a wide range of conditions related to women's reproductive health.

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