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Postponing pregnancy seeking and anticipating infertility treatments: an unwise combination

Somigliana, E; Busnelli, A; Vigano', P; Vegetti, W; Goisis, A; Vercellini, P; (2020) Postponing pregnancy seeking and anticipating infertility treatments: an unwise combination. Reproductive Biomedicine Online (In press).

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Abstract

Research Question: Natural fecundity and IVF-ICSI success rate both decrease with age. For this reason, in women older than 35, it is generally recommended to initiate the infertility work-up earlier. However, this assumption may expose couples to over-diagnosis and over-treatment. Design: To shed light on this issue, we developed a theoretical model aimed at assessing the effects of starting the infertility work-up after 6 rather than 12 months of pregnancy seeking The assumptions of the model were: 1) infertile women are straightly treated with IVF-ICSI for up to three cycles; 2) IVF-ICSI success rate at first cycle linearly declines with age (3% per year), 3) the drop-out rate after the 1st and 2nd 29 cycle is 18% and 25%, respectively, 4) the relative reduction of the success rate at 2nd and 3rd 30 cycle is 16% and 26%, respectively. Results: On these bases, the anticipation moderately improved the cumulative chances of live birth of a full IVF-ICSI program. This improvement depended on age. Specifically, it increased from 2.0% at age 35 to 3.0% at age 43. Conversely, the incremental success rate per single IVF cycle was mainly stable, varying only from 1.4% at age 35 to 1.3% at age 43. Conclusions: In women older than 35, anticipation of the infertility work-up is associated with only a modest increase in the rate of success of IVF-ICSI. In most scenarios, this advantage may compare unfavorably with the chances of natural conception during the 6 months period.

Type: Article
Title: Postponing pregnancy seeking and anticipating infertility treatments: an unwise combination
Publisher version: https://www.rbmojournal.com/inpress
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Education
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education
UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Social Research Institute
URI: https://discovery.ucl.ac.uk/id/eprint/10088111
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