Prognostic value of first IVF cycle on success of a subsequent cycle.

OBJECTIVE

To determine whether a live birth or miscarriage in a previous IVF cycle is predictive of success in a subsequent cycle.

DESIGN

Retrospective study

SETTING

Private IVF unit

PATIENTS: 1141 couples having a second IVF cycle.

INTERVENTION: 3 groups; Group I: women who had a live birth in the first cycle, Group II those who had a miscarriage, Group III, women who had a negative pregnancy test in their first cycle.

OUTCOME MEASURES: Pregnancy (PR), Live birth (LBR) & miscarriage rates in the second cycle.

RESULTS

For women < than 40: PR was 46.4% (368/793), miscarriage rate was 29.9% and the LBR was 32.5% (258/793). Women in groups I & II had a statistically higher PR than those in group III 63.3% v 55.2% v 41.9% respectively. LBR was higher 45% v 37.8 v 29.6% respectively. Miscarriage rate was similar. For women 40 years and older: The PR was 21.0% (73/348), miscarriage rate was 52.1% (38/73) and the LBR was 10.1% (35/348).There was no significant difference in PR among women in groups I, II & III. The LBR and miscarriage rates were similar in all groups.

CONCLUSION

Young women who had a live birth and those who experienced an early miscarriage after IVF have a greater likelihood of achieving a live birth in a second cycle. Outcome of first IVF cycle however does not predict subsequent IVF success in older women.