Cumulative conception and live birth rates in natural (unstimulated) IVF cycles

IVF treatment, which involves ovarian stimulation, poses significant health problems such as ovarian hyperstimulation and is associated with a high in cidence of multiple pregnancy and premature birth. In this paper, we demons trate how natural cycle IVF is an effective and potentially cost-effective alternative treatment option for certain groups of infertile couples. The s tudy was conducted in the Assisted Conception Unit at King's College School of Medicine, London. Fifty-two women with regular menstrual cycles whose p artners had normal semen parameters were offered a total of 181 cycles of t reatment (average 3.49 per couple). Life table analysis was used to calcula te cumulative success rates after successive cycles of treatment. After fou r cycles, the cumulative probability of pregnancy was 46% with an associate d live birth rate of 32%. To achieve maximal effectiveness, natural cycle I VF should be offered as a series of treatment cycles, for it is safer, less stressful and can be offered over consecutive cycles. Moreover, the avoida nce of expensive drugs and reduced intensity of monitoring make natural cyc le IVF less expensive than conventional treatment involving stimulation. We calculate that this treatment can be offered at similar to 23% of the cost of a stimulated cycle, suggesting that it may be a cost-effective alternat ive to conventional assisted conception techniques.