In-vitro fertilisation, or IVF for short, is an assisted reproductive technique (ART) for couples who haven’t been able to conceive naturally. The first IVF baby was born in 1978, and since then, IVF has come a long way from its early years of single-digit success rates.
Today, in IVF cases where the woman is 35 years old or younger, there is roughly a 50% chance of success. In Singapore, IVF success rates tend to range from 50 to 60%, and most couples can get pregnant by their third cycle.
Yet, even with IVF technology, expertise, and techniques on a sure and constant rise, it remains that IVF can cause a huge emotional and relational toll on unsuccessful patients. After a failed first treatment cycle, couples are at increased risk of depression, and 1 in 8 women develop a clinically relevant form of depression. IVF can also be physically demanding.
If you’re considering in-vitro fertilisation, It is crucial to set yourself up for success before taking that leap of faith. Here’s how.
Factors that affect the success of IVF
Age
Many factors affect the success rates of IVF, and perhaps the most critical one is age. Women under 30 have a pregnancy rate of 25.4% per egg transfer. This decreases to 17.7% in women aged between 31 to 35, and 9.7% in women aged 36 to 40.
Number of embryos
In IVF, one other critical factor is the number of embryos a patient is transferring. In Singapore, 2 embryos can be transferred in one procedure. If 2 embryos were transferred and the woman gets pregnant, the chances of her delivering twins are less than 10%. Another key factor to consider when choosing how many embryos to transfer is that the odds of a multiple birth increase as the embryo count goes up.
Number of treatment cycles
Notably, the possibility of success decreases with each IVF treatment cycle. Most women typically see success rates of 20-35% per cycle, but the likelihood of getting pregnant decreases with each successive round, while the cost increases. The cumulative effect of three full cycles of IVF increases the chances of pregnancy to roughly 50%.
How can I increase my chances of IVF?
Apart from making sure that you choose the right doctor and clinic for you, there are other actions you can take at home to ensure that you’re setting yourself up for fertility success.
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Tip |
Why it’s important |
| Maintain a healthy weight | Maintaining a healthy weight is extremely important. Being obese and underweight increases conception times by 2 and 4 times respectively, and negatively affects IVF success rates. Being overweight also makes monitoring one’s ovaries more difficult, and can increase the chance of complications during egg retrievals. |
| Optimize sperm health | Infertility affects 1 in 6 couples in Singapore. In 40% of couples, the cause of infertility is attributed to a sperm factor or male infertility. Use of multivitamins and medications, maintaining optimal body weight and quitting smoking could improve sperm quality. |
| Reduce your stress levels | Stress can shut down the activity of the hypothalamic-pituitary-gonadal axis, which controls your reproductive system. This can disrupt the connection between your brain and your ovaries and end up causing delayed or absent bleeding and ovulation periods. |
| Quit smoking | Smoking can negatively affect egg and sperm quality – Infertility rates in smokers is roughly twice the rate of infertility in nonsmokers. The infertility risk also goes up with the number of cigarettes smoked daily. |
| Start taking supplements | DHEA and CoQ10 have been shown to increase antral follicle count and the ovaries’ response to medication during an IUI or IVF cycle. |
| Get enough Vitamin D | A new study has found that women with appropriate levels of vitamin D were 34% more likely to have a positive pregnancy test following ART, 46% more likely to achieve a clinical pregnancy, and ⅓ more likely to have a live birth than women with low levels of vitamin D. |
When should I start preconception care for IVF?
Preconception care should begin at least three months before you get pregnant. However, each woman is different, and some individuals might need more time to get their bodies ready for pregnancy. Be sure to take your partner’s health into account too.
During this process, a few key discussions need to take place. You should cover:
- Any vaccines and screenings you may need, such as a pap smear, or HIV test.
- Existing health problems, such as diabetes, thyroid disease, depression and more, and how it may affect your pregnancy and vice versa.
- Ways to improve your overall health (eg. diet changes, stopping cigarette use)
- Hazards in your environment that could harm you or your baby
- Health problems that run in your or your partner’s family
- Problems you have had with prior pregnancies (eg. miscarriages)
- Other concerns that could affect your health (eg. lack of support)
Can using frozen eggs help increase IVF success rates?
In recent years, freezing embryos before fertilising and transferring them has been found to increase IVF success rates. The underlying theory is that egg freezing singles out the most resilient eggs that have a higher chance of resulting in pregnancy. Transferring frozen embryos is a common practice among IVF clinicians.
References
- Eskew, A. M., & Jungheim, E. S. (2017). A History of Developments to Improve in vitro Fertilization. Missouri Medicine, 114(3), 156–159.
- Verhaak, C. M., Smeenk, J. M., Kremer, J. A., Braat, D. D., & Kraaimaat, F. W. (2002). De emotionele belasting van kunstmatige voortplanting: meer angst en depressie na een mislukte eerste behandeling [The emotional burden of artificial insemination: increased anxiety and depression following an unsuccessful treatment]. Nederlands tijdschrift voor geneeskunde, 146(49), 2363–2366.
- Templeton, A., Morris, J. K., & Parslow, W. (1996). Factors that affect the outcome of in-vitro fertilisation treatment. Lancet (London, England), 348(9039), 1402–1406. https://doi.org/10.1016/S0140-6736(96)05291-9
- Michelmann, H. W., Micheels, P., & Mettler, L. (1987). Einfluss des mütterlichen Alters auf die Erfolgsrate bei der In-vitro-Fertilisation. Ein Vergleich humaner und tierexperimenteller Daten [Effect of maternal age on the success rate of in vitro fertilization. A comparison of human and animal experiment data]. Geburtshilfe und Frauenheilkunde, 47(7), 495–498. https://doi.org/10.1055/s-2008-1035860
- Kumar, N., & Singh, A. K. (2015). Trends of male factor infertility, an important cause of infertility: A review of literature. Journal of Human Reproductive Sciences, 8(4), 191–196. https://doi.org/10.4103/0974-1208.170370