Ask Dr. Marc.....How many IVF's should I do?

Dear Dr. Marc,

My husband and I have been trying to have a child for 4 years now. We started seeing a fertility specialist 2 years ago and in that time have undergone 3 cycles of clomid, 2 cycles of injectable medicine with IUI and 3 cycles of IVF.  My question is how many cycles of IVF do you recommend.  Any advice you have would be helpful.

Thanks,

IVF-times 3 

Hi IVF times 3,

First I think it is worthwhile to acknowledge the amount of hard work it takes to go through 3 IVF cycles.  Each cycle is grueling and definitely takes an emotional, physical and financial toll.  You obviously are determined to make this work and I believe that your determination will pay off!

In terms of how many IVF cycles you should attempt, it depends on several details specific to your situation. 

1.       Age- We know that younger women have a greater chance of conceiving with their own eggs than older women.  Therefore, younger women tend to warrant more cycles than older women.   Additionally, women who are 43 years of age and older have especially low live birth rates with their own eggs.  In this age group, some believe that multiple cycles of IVF is inappropriate. 

2.       Your prior cycles- Did your prior cycles go well?  Did you make many eggs?  Was the embryo quality good? If the cycle went well, there is reason to consider trying again, if the cycle did not go very well, are there things about the cycle that can be changed which would give you a better chance in the future?

3.       Other factors- What other factors contributed to the failures?  Are there problems with the sperm which can be corrected?  Is there a uterine factor?  Are there environmental issues which could be affecting your chances? Sometimes, you have to think a bit “outside to box” to come up with fresh ideas.

The bottom line is that there is no specific number of IVF cycles a person should undergo.  For you, I believe that if there are changes that can be made for your next cycle, you should consider trying again.   If however, you are over 42, or are a very low responder despite different stimulation protocols, you may want to consider some alternatives.  Those alternatives include mini IVF, natural IVF, donor oocyte IVF or adoption. 

Ultimately, the decision to pursue another cycle is an individual one.  As long as you make the decision based on realistic expectations and honest counseling, I don’t think you will go wrong.

Good luck, and hopefully the fourth time will be a charm!

Dr. Marc