CONFOUNDING VARIABLES AFFECTING IN-VITRO FERTILIZATION SUCCESS - A DECADE OF EXPERIENCE

Purpose: To evaluate etiology of infertility, female age, ovarian resp onse and stimulation protocol in affecting in vitro fertilization (IVF ) success. Methods: Retrospective analysis was used. Computer records of all 5209 cycles initiated in 2391 couples from February 1, 1984 to December 31, 1993 were analyzed. Results: There were 644 intrauterine, 24 solely ectopic and 7 heterotopic pregnancies. Pregnancy rates incr eased with number of embryos transferred with a significant increase s till found between transfer of three or four embryos. Multiple gestati ons also increased in association with an increasing number of embryos transferred. Pregnancy rates per cycle did not decline with repeated cycles. Reduced pregnancy rates were associated with a primary diagnos is of male infertility. Covariates associated with a better pregnancy rate were younger age of the female partner or higher peak preovulator y serum estradiol. Routine administration of GnRH-agonist was associat ed with a reduced cycle cancellation Fate, an increase in oocytes retr ieved and an improved pregnancy rate. Conclusions: Couples with male i nfertility and increased female age should be counselled regarding the reduced prognosis for success.