Advertisement

Only women’s age and the duration of infertility are the prognostic factors for the success rate of natural cycle IVF

  • Michael von WolffEmail author
  • Alexandra Kohl Schwartz
  • Norman Bitterlich
  • Petra Stute
  • Monika Fäh
Gynecologic Endocrinology and Reproductive Medicine
  • 24 Downloads

Abstract

Purpose

It is controversial who should be recommended to undergo natural cycle IVF (NC-IVF). Therefore, objective prognostic criteria which are already known at the time of counselling were defined.

Methods

A retrospective observational study was performed with 201 couples (age 34.7 ± 4.1) undergoing 311 NC-IVF treatments with 201 transfers, corresponding to a transfer rate of 65.3%. The first cycle resulting in a transfer of one embryo was further analysed. Clinical pregnancy and live birth rates were analysed.

Results

Pregnancy rate and live birth rates per first cycle were 21.9% and 13.2%, respectively. Groupwise comparison revealed the following clinical pregnancy/live birth rates per transfer cycle: duration of infertility 1–2 years 34.3/25.7%, 3–4 years 21.8/14.9% and > 4 years 9.1/4.5%. Women’s age  < 34 years 26.3/22.4%, 34–37 years 25.7/18.9% and 38–42 years 15.7/3.9%. Linear regression analysis showed that pregnancy and live birth rate correlated negatively with the duration of infertility and that live birth rate but not pregnancy rate correlated negatively with increasing female age. In contrast, AMH and infertility factors did not correlate with the success rate. Statistically significant correlations remained if a multivariate logistic regression analysis was performed, supporting further that the duration of infertility (OR 0.61, 95% CI 0.42–0.86) (P = 0.006) and female age (OR 0.87, 95% CI 0.78–0.95) (P = 0.008) are the predictors for live birth rates in NC-IVF transfer cycles.

Conclusions

Based on the success rates, NC-IVF can especially be recommended for women with short duration of infertility and young age, whereas older women and those with long duration of infertility are not the best candidates for this technique.

Keywords

Pregnancy rate Live birth rate Natural cycle IVF Prognostic factors Age 

Notes

Acknowledgements

We would like to thank Dr. Elizabeth Kraemer for the linguistic revision and correction of the manuscript.

Author contributions

MvW: design of the study, analysis of data and writing of the manuscript. AKS: preparation of data. NB: statistics. PS: preparation of data. MF: preparation of data. All authors contributed to the manuscript revision, read and approved the submitted version.

Funding

This study was not funded.

Compliance with ethical standards

Conflict of interest

None of the authors have declared a conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Gordon JD, DiMattina M, Reh A, Botes A, Celia G, Payson M (2013) Utilization and success rates of unstimulated in vitro fertilization in the United States: an analysis of the Society for Assisted Reproductive Technology database. Fertil Steril 100:392–395CrossRefGoogle Scholar
  2. 2.
    FIVNAT annual reports of Swiss IVF IVF registry “Fécondation In Vitro National” www.fivnat-registry.ch. Accessed 30 Dec 2018
  3. 3.
    Haemmerli Keller K, Alder G, Faeh M, Rohner S, von Wolff M (2018) Three natural cycle IVF treatment imposes less psychological stress than one conventional IVF treatment cycle. Acta Obstet Gynecol Scand 97:269–276CrossRefGoogle Scholar
  4. 4.
    von Wolff M, Rohner S, Santi A, Stute P, Popovici R, Weiss B (2014) Modified natural cycle in vitro fertilization an alternative in vitro fertilization treatment with lower costs per achieved pregnancy but longer treatment time. J Reprod Med 59:553–559Google Scholar
  5. 5.
    Aleersma T, Farquhar C, Cantineau AE (2013) Natural cycle in vitro fertilisation (IVF) for subfertile couples. Cochrane Database Syst Rev 8:CD010550Google Scholar
  6. 6.
    van Loendersloot LL, van Wely M, Limpens J, Bossuyt PM, Repping S, van der Veen F (2010) Predictive factors in in vitro fertilization (IVF): a systematic review and meta-analysis. Hum Reprod Update 16:577–589CrossRefGoogle Scholar
  7. 7.
    Wang YA, Healy D, Black D, Sullivan EA (2008) Age-specific success rate for women undertaking their first assisted reproduction technology treatment using their own oocytes in Australia, 2002–2005. Hum Reprod 23:1633–1638CrossRefGoogle Scholar
  8. 8.
    González-Foruria I, Peñarrubia J, Borràs A, Manau D, Casals G, Peralta S, Creus M, Ferreri J, Vidal E, Carmona F, Balasch J, Fàbregues F (2016) Age, independent from ovarian reserve status, is the main prognostic factor in natural cycle in vitro fertilization. Fertil Steril 106:342–347.e2CrossRefGoogle Scholar
  9. 9.
    Kasius A, Smit JG, Torrance HL, Eijkemans MJ, Mol BW, Opmeer BC, Broekmans FJ (2014) Endometrial thickness and pregnancy rates after IVF: a systematic review and meta-analysis. Hum Reprod Update 20:530–541CrossRefGoogle Scholar
  10. 10.
    Mitter V, Kohl Schwartz A, Fäh M, Griesinger G, von Wolff M (2017) Endometrial thickness is associated with the clinical pregnancy rate in unstimulated menstrual cycles—a study based on natural cycle IVF. Hum Reprod 32(Supp 1):i351–i352Google Scholar
  11. 11.
    von Wolff M, Nitzschke M, Stute P, Bitterlich N, Rohner S (2014) Low-dosage clomiphene reduces premature ovulation rates and increases transfer rates in natural-cycle IVF. Reprod Biomed Online 29:209–215CrossRefGoogle Scholar
  12. 12.
    von Wolff M, Hua YZ, Santi A, Ocon E, Weiss B (2013) Follicle flushing in monofollicular IVF almost doubles the number of transferable embryos. Acta Obstet Gynecol Scand 92:346–368CrossRefGoogle Scholar
  13. 13.
    Kawachiya S, Matsumoto T, Bodri D, Kato K, Takehara Y, Kato O (2012) Short-term, low-dose, non-steroidal anti-inflammatory drug application diminishes premature ovulation in natural-cycle IVF. Reprod Biomed Online 24:308–313CrossRefGoogle Scholar
  14. 14.
    von Wolff M (2018) The role of natural cycle IVF in assisted reproduction. Best Pract Res Clin Endocrinol Metab.  https://doi.org/10.1016/j.beem.2018.10.005

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Gynaecological Endocrinology and Reproductive MedicineUniversity Women’s Hospital, Inselspital, University HospitalBernSwitzerland
  2. 2.Medizin and Service GmbHChemnitzGermany

Personalised recommendations