This sounds too good to be true. But new research from the University of Aberdeen offers hope for couples who have not been successful in IVF treatment. The team found that 1 in 6 women who had been unsuccessful in IVF treatment actually went on to have a child naturally [1. ElMokhallalati Y, Van Eekelen R, Bhattacharya S, McLernon DJ. Treatment- independent live birth after in- vitro fertilisation: a retrospective cohort study of 2,133 women. Human Reproduction. 2019. 34(8):1470-1478.].
What is IVF?
IVF (in-vitro fertilisation) is a fertility treatment which involves doctors removing eggs from a woman’s body and fertilising them using her partner’s sperm cells in a laboratory. The fertilised egg is then returned to the woman’s body where it will develop as normal during pregnancy.
ICSI (intracytoplasmic sperm injection) is a method of IVF treatment. It involves a doctor injecting a single sperm into an egg cell. This is used in cases where a man has fertility problems as it allows doctors to select the best sperm cells.
What happened in the study?
In the study which was published in the journal Human Reproduction, scientists studied data from 2,133 women. These women had received IVF treatment at a fertility clinic in Aberdeen between 1998 and 2011.
The team divided the population of women into two groups based on whether their fertility treatment had been successful or not, and they followed up these women to determine whether they gave birth independently of their treatment. The women were followed up for at least one year after their last fertility treatment cycle, with the maximum follow up time being 15 years.
What were the results of the study?
Out of the 2,133 women who underwent IVF treatment, 1060 women were successful in their fertility treatment and they had a live birth. Out of these women, 15% went on to have another live birth within five years, independently of treatment.
The remaining 1,073 women who underwent IVF treatment either did not become pregnant as a result of the treatment or they suffered a miscarriage. Out of these women 17%, or just over 1 in 6 women, surprisingly went on to conceive naturally without any treatment within five years.
Which factors can affect the chances of conceiving naturally?
The team found that certain factors affected the chances of having a baby naturally after a fertility treatment. The chances of conceiving naturally were higher in women who were younger or in cases where they had been infertile for a shorter period of time. Additionally having IVF treatment as opposed to ICSI treatment resulted in a higher chance of giving birth independently of treatment.
In women who were not successful in IVF treatment, the team found that they were less likely to conceive naturally if they had tubal factor infertility. This type of infertility occurs when there is a blockage in the fallopian tube which prevents the egg and sperm from coming into contact with each other. There are many causes of this condition including endometriosis and pelvic inflammatory diseases.
In women who were successful in IVF treatment, they had a lower chance of conceiving naturally independently of treatment if they had gone through three or more previous IVF or ICSI transfers.
How reliable is this study?
Some other studies have investigated this area of research but they have used a much smaller population of participants and have often had poor response rates. However this study is thought to be the biggest of its kind as it uses data from over 2,000 women. Therefore this means the results of this study are more meaningful and offer hope for couples who have been unsuccessful in fertility treatments.
However it is important to note that the treatments all took place at one fertility centre. This may mean that the results are not applicable to a wider population of people in different areas.
Additionally, the team did not take into account any information about women’s contraceptive use or their active attempts to get pregnant. Both of these factors would affect the chances of a woman becoming pregnant naturally.
What are the criteria for having IVF treatment?
The National Institute for Clinical Excellence (NICE) sets out the criteria for which women can have IVF treatment funded by the NHS. NICE recommends IVF for women who are under 43 years old, because the chances of success reduce with age.
These women need to have tried to become pregnant naturally through unprotected intercourse for 2 years. Alternatively, IVF is also recommended for women who have gone through 12 cycles of intrauterine insemination (IUI). This procedure involves a doctor inserting sperm cells directly into a woman’s womb.
It is important to bear in mind that even if you meet these conditions, the exact criteria for treatment can vary according to your area. In regions with stricter criteria, other factors such as being a healthy weight and not smoking may affect whether you are eligible for NHS funded treatment. Additionally the number of IVF cycles funded by the NHS can differ according to your area. Therefore it is best to clarify your options with your fertility doctor.
However if women do not meet the criteria for NHS-funded IVF, they are still able to undergo IVF treatment through private clinics. The costs of these can vary so it is important to research and compare fertility clinics carefully, as one cycle of IVF treatment can cost up to £5,000. Medicines, consultations and other expenses may be charged separately, so make sure you ask about the full cost of treatment including extras.
Going abroad for IVF treatment is another option which can be cheaper than private clinics in the UK. Prices vary with some clinics in the Czech Republic offering an IVF cycle for £1,500. However these prices do not include the cost of travel and accommodation.
Additionally it is important to remember that clinics abroad are less strictly regulated than UK clinics. Therefore it is even more important to research them thoroughly, particularly in terms of their success rates.
What are the IVF success rates in the UK?
The success rates of IVF treatments vary according to the cause of a woman’s fertility problems and her age. For women under 35 years old, the average success rate for IVF is 29%.
This drops to 24% for women who are aged between 35 and 37 years old, and the success rate continues to fall with a woman’s age. The success rate for women over 44 years old is only 3%.
IVF treatment is a difficult process and it is physically, emotionally and mentally demanding. This is the case regardless of whether the treatment is successful. Therefore the team at the University of Aberdeen hope that their results can help couples to make a more informed decision about their options when they are trying to have a baby.
It is really disappointing to have gone through the challenges of IVF treatment and receive an unsuccessful outcome. But this study sheds some light on the options available after IVF treatment and the possibility of still having a baby naturally. If you are trying to have a baby and need more advice it is best to discuss this with your GP or fertility doctor.