title: Analysis of the fourth to eighth in-vitro fertilization treatments after three previously failed attempts.
abstract: The fourth to eighth in-vitro fertilization cycles of patients who had previously reached the stage of embryo transfer without conceiving were evaluated. A total of 426 cycles were received in women ranging in age from 25 to 46 years. The patients underwent from four (169 women) to eight (27 women) treatment cycles, using four established protocols for induction of ovulation. There was no statistical difference in the age, aetiology, duration of infertility and distribution of the various protocols among the analysed groups. The pregnancy rates in cycles 4-8 were 19.5, 15.4, 10.8, 16.7 and 11.8% respectively (mean 16.2% per cycle) and were not statistically different. There was no trend of reduced success when the number of attempts increased. The overall live birth rate was 12.4%. The pregnancy rate was comparable between age groups. No protocol proved to be significantly superior to others when pregnancy rate per embryo transfer was assessed. We concluded that the pregnancy rate in cycles 4-8 was stable, including those of patients up to 42 years of age. Continuous efforts are therefore advised for at least up to this age and number of attempts. A change of an induction protocol in subsequent cycles, after repeated failure, is not statistically justified.
authors.affiliation: IVF Unit, Serlin Maternity Hospital, Tel Aviv Sourasky Medical Center, Israel.
authors.forename: I
authors.initials: I
authors.lastname: Yovel
authors.forename: E
authors.initials: E
authors.lastname: Geva
authors.forename: J B
authors.initials: JB
authors.lastname: Lessing
authors.forename: Y
authors.initials: Y
authors.lastname: Yaron
authors.forename: A
authors.initials: A
authors.lastname: Botchan
authors.forename: A
authors.initials: A
authors.lastname: Amit
mesh_terms: D000328:Adult; D000367:Age Factors; D006063:Chorionic Gonadotropin / Q000008:administration & dosage / Q000627:therapeutic use; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome
chemical_list: D006063:Chorionic Gonadotropin