Success Rates of In Vitro Fertilization

choi

Catherine Saint Louis, Study on In Vitro Birth Says Persistence Can Pay Off. New York Times, Dec 23, 2015.

the first two paragraphs:

"In their quest to become parents, most infertile couples undergoing in vitro fertilization must grapple with a tough decision: when to call it quits. After three or four unsuccessful embryo transfers, doctors have long assumed that the chances of eventually bringing home a child were dismal.

"But a large study [from UK], published on Tuesday in the Journal of the American Medical Association, has found that nearly two-thirds of women undergoing I.V.F. will have a child by the sixth attempt, suggesting that persistence can pay off, especially for women under 40.


, which essentially recaps

Smith ADAC et al, Live-Birth Rate Associated With Repeat In Vitro Fertilization Treatment Cycles. Jpurnal of American Medical Association, 314: _ (online publication Dec 22, 2015.
jama.jamanetwork.com/article.aspx?articleid=2478204

Quote:

(a) Abstract:

(i) "Prospective study of 156 947 UK women who received 257 398 IVF [in vitro fertilization] ovarian stimulation cycles between 2003 and 2010 and were followed up until June 2012. * * * with a cycle defined as an episode of ovarian stimulation [with hormones] and all subsequent separate fresh and frozen embryo transfers.

(ii) "Results[:]  Among the 156 947 women, the median age at start of treatment was 35 years (interquartile range, 32-38; range, 18-55), and the median duration of infertility for all 257 398 cycles was 4 years (interquartile range, 2-6; range, <1-29). In all women, the live-birth rate for the first cycle was 29.5% (95% CI, 29.3%-29.7%). This remained above 20% up to and including the fourth cycle. The cumulative prognosis-adjusted live-birth rate across all cycles continued to increase up to the ninth cycle, with 65.3% (95% CI, 64.8%-65.8%) of women achieving a live birth by the sixth cycle. In women younger than 40 years using their own oocytes, the live-birth rate for the first cycle was 32.3% (95% CI, 32.0%-32.5%) and remained above 20% up to and including the fourth cycle. Six cycles achieved a cumulative prognosis-adjusted live-birth rate of 68.4% (95% CI, 67.8%-68.9%). For women aged 40 to 42 years, the live-birth rate for the first cycle was 12.3% (95% CI, 11.8%-12.8%), with 6 cycles achieving a cumulative prognosis-adjusted live-birth rate of 31.5% (95% CI, 29.7%-33.3%). For women older than 42 years, all rates within each cycle were less than 4%. No age differential was observed among women using donor oocytes. Rates were lower for women with untreated male partner–related infertility compared with those with any other cause, but treatment with either intracytoplasmic sperm injection or sperm donation removed this difference.

(b) Introduction: "In vitro fertilization (IVF) is commonly stopped after 3 or 4 unsuccessful embryo transfers * * * This practice has been influenced by a study of 1328 embryo transfers undertaken 20 years ago, without use of intracytoplasmic sperm injection (ICSI), which reported a decline in live-birth rates after the fourth cycle. With 1 exception, previous studies of cumulative pregnancy or live-birth rates have been relatively small

(c) Results:

"Results varied by age and oocyte 卵子 source (Figure 2 [whose legend states, 'Data for women older than 42 years at their first treatment cycle are not shown because rates were so low it would have been difficult to represent them on this same graph']

Note:
(a) Interquartile range
https://en.wikipedia.org/wiki/Interquartile_range
(IQR;  "IQR = Q3 −  Q1. In other words, the IQR is the 1st quartile subtracted from the 3rd quartile"/ section 4 Interquartile range and outliers)

In the box plot, the left wing and right wing (both shaded LIGHT blue) should be 25% each. HOWEVER, to the left of "Q1 minus 1.5 x IQR" (colored white) is 0.35% (which section 4 identifies as where "outliers" stay).
(b) In Figure 2, the top line use "Donor oocytes" as opposed to "Own oocytes."
(c) The last sentence of quotation (a)(ii) is explained in Figure 3, where the "treatment" for "[w]omen whose infertility was due to a male-related cause" refers to "intracytoplasmic sperm injection (ICSI) or sperm donation."