This post was updated on May 20th, 2019
Back when we were teenagers, “family planning” was a euphemism for “using protection”, which was another euphemism for “using condoms strictly as instructed every time sexual intercourse occurred otherwise you will get pregnant.”
The “health” education most of us had was enough to have us paranoid about the super-powers of sex to get us pregnant. But like many women in their 30’s who have failed to fall pregnant despite doing the exact opposite of what we learned from sex education, the words “family planning” have taken on a new, and much more serious meaning for me. Especially when it comes to IVF and IVF success rates.
Your success rates of IVF depends on how many children you want
Here is a simple idea I want to share with those of you interested in the success rates of IVF and also seeking fertility treatment which your fertility specialist may or may not have put to you before:
How many children do you want?
Like I have spoken about in my own personal infertility story this was not a question any fertility specialist asked me until I met the current specialist I now see and I do not think it is a commonly considered question by most fertility specialists. Normally the consideration is getting you pregnant this one time. But in doing that you may completely miss out on your opportunity of getting pregnant a second or even third time because of age related fertility decline.
So I would like to encourage you when seeking fertility treatment, to ensure the solutions you pursue are aligned with the number of children you would ultimately like to have.
If you only want one child, then this is a mute point. You want a baby, and you want it now, and you should do whatever you think is best to achieve that relatively short-term goal. End of story.
If however, you’re like me, and would ultimately like to have two or three children, then it is vital that you’re fertility treatment takes this into account.
If all of us were so lucky
In some cases fertility diagnosis and other factors such as financial constraints, this may unfortunately not be an option because just getting pregnant the one time is the focus. But for others I do hope this can be a bit of an eye opener to the decline in IVF success rates by age before you start down the road of IVF.
Let me give you an example to show you why IVF success rates by age is so important:
My case study friend
On the topic of IVF success rates by age, let us imagine a married, otherwise healthy woman, who has just turned 35, with no kids yet but would like to have three. She’s been unable to fall pregnant after 12 months of timed intercourse with her husband, and has recently been diagnosed with tubular blockage and hence IVF treatment is the planned course of action.
Let’s assume:
- It takes 3 months for this woman to get pregnant (a fairly optimistic assumption)
- She wait’s two years between having children, and
- She chooses to only transfer one embryo at a time because she wants to mitigate the risks of having a multiple birth.
“As-you-go” success rate of IVF
If our case-study chooses to undergo IVF each time she wants a baby then statistically speaking, her IVF success rate with each birth are shown in the figure below.
Figure 1. Cumulative live birth rates for the general population of women undergoing IVF. See my IVF success rates blog article for further information including data sources.
The cumulative live birth rate above represents the chances of having a baby after multiple IVF attempts, potentially spanning several years, and hence these numbers are pretty optimistic for our case study patient who we have assumed manages to get pregnant within 3 months every time.
This decline in probable success rates can also be seen using my IVF Success Rates Calculator with our subjects per fresh embryo transfer cycle success rate dropping from 27% for babies 1 and 2, to 12% for baby number 3.
IVF success rates with a “family planning” approach
A “family planning” approach to IVF treatment for this woman would differ to the “as-you-go” method described above in the following key ways:
- Our case study subject would complete multiple egg retrievals and fertilizations to produce a cache of frozen embryos in her first year of treatment.
- She would determine “how many embryos are enough” by using my Multiple Live Birth IVF Success Rates Table. By my estimates, a clutch of 12 embryos would give her an approximately 67% success rate of IVF and successfully having three children, and an 88% success rate of IVF and a chance of having two.
- She would then use the embryos which she had frozen while 35 years old, for her second and third child.
The difference in this approach is that her chances of success with babies #2 and #3, will basically be the same as they were for the first. By freezing her embryo’s for a few years, our case study subject has effectively eliminated the decline in her fertility with age and thus given herself the best chance of having three children.
The Financial Benefits of Family Planning
While the family planning approach to IVF is clearly the better option, a quick review of the financial costs also reveals this is the better approach when considering the cost of all three births.
The cost of IVF “as-you-go”
In comparison, is the “as-you-go”method. The table below shows a hypothetical calculation of the IVF treatment requirements in order for our case study subject to have an 80% chance of having three children.
- The thawed embryo success rates come from my IVF success rate calculator (interpolated to give greater age definition)
- The number of embryos required comes from my Multiple Live Births IVF Success Rates Table, and
- The percentage of embryos with the correct number of chromosomes comes from figure 1 of Your Ultimate Guide To Egg Freezing.
Table 1. Estimated number of embryo transfer cycles, and eggs required for IVF “as-you-go”.
While I’m not suggesting that anyone wanting three children should undergo this much IVF treatment, the example above shows that at least 46 eggs will need to be retrieved, in order to produce 19 viable embryos, if the our case study subject wants an 80% chance of having three children when following an IVF-as-you-go strategy.
The comparative cost of the “family planning” approach
By comparison, keeping all things equal, if our case study subject had collected additional eggs for babies #2 and #3 when she was 35 years old, she would only need to collect a total of 24 eggs and undergo 15 embryo transfers to have the same probability of having three children as the IVF-as-you-go strategy.
This reduced demand for both eggs and embryo transfers will save the couple in this case study thousands of dollars, over their reproductive years.
Commercially it is better for IVF Clinics to not use family planning
I definitely felt exceptionally lucky that my fertility specialist brought up the subject of family planning from an IVF perspective when I first went to see him. While ethically this is a no-brainer, as a trained economist, I couldn’t help but think that family planning with IVF may not be as lucrative for IVF clinics than an “as-you-go” type plan…
As my example shows, IVF clinics have far more revenue making opportunities with the IVF “as-you-go” strategy than the family planning one. While clearly I’m lucky to have a great specialist; my concern is that not every professional will be so upstanding and transparent with their patients.
As for all things health related, at the very least, this example shows that the best person to ensure your fertility interests are number one is you. So think about the long-game when seeking IVF treatment, as well as just that first baby out of the blocks ☺
If you’re planning on doing IVF I would love to know your thoughts on the success rates of IVF in the comments section below!
Xo Kym
Since 2010, Kym Campbell has used evidence-based diet and lifestyle interventions to manage her PCOS. After getting her symptoms under control and falling pregnant naturally, Kym now advocates for dietary change as part of any PCOS treatment plan. Combining rigorous science and clinical advice with a pragmatic approach to habit change, Kym is on a mission to show other women how to take back control of their health and fertility. Read more about Kym and her team here.
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