Cumulative probability of clinical pregnancy and live birth after a multiple cycle IVF package: A more realistic assessment of overall and age-specific success rates?

Objective To provide an assessment of pregnancy and live birth probabilitie s for women presenting for in vitro fertilisation treatment for the first t ime, when committed in advance to have up to three cycles of treatment in o ne year. Design Up to three cycles of in vitro fertilisation within one year, commit ted in advance. Setting A tertiary referral centre for assisted reproduction. Participants Two hundred and thirty-two women, undergoing a total of 536 cy cles of in vitro fertilisation or intracytoplasmic sperm injection between August 1993 and December 1995. Methods Analysis of cumulative clinical pregnancy and live birth rates for women having IVF treatment for the first time and undertaking a three-cycle package, using the life-table approach. Main outcome measures Cumulative clinical pregnancy and live birth rates. Results The cumulative probabilities of clinical pregnancy and live birth a fter two cycles of treatment were 38.2% and 33.2%, respectively, compared w ith 54.2% and 48.2%, respectively, after three cycles of treatment. Cumulat ive clinical pregnancy and live birth rates after three cycles of treatment for women up to the age of 40 years were 57.8% and 51.3%, respectively. Cu mulative clinical pregnancy and live birth rates declined with increasing a ge (P = 0.02 and P = 0.01, respectively). Conclusion The three-cycle package encourages couples to have multiple trea tment cycles, thereby improving their ultimate chances of a live birth. The cumulative clinical pregnancy and live birth rates after such a package pr ovide a more realistic assessment of overall and age-specific success rates after multiple treatment cycles.