title: Lower chance of pregnancy with repeated cycles with in vitro fertilization.
abstract: OBJECTIVE
  To evaluate pregnancy outcomes in initial and replicate IVF cycles.
  
  
  METHODS
  A retrospective analysis of 2,167 fresh, nondonor IVF cycles performed in a large private practice from January 1, 2005, to March 1, 2006. Standard controlled ovarian hyperstimulation and laboratory protocols were followed.
  
  
  RESULTS
  Patients undergoing multiple treatment cycles were significantly older. There was no difference in body mass index or percentage of cancelled cycles with increasing number of IVF attempts. The number of retrieved, mature and fertilized oocytes progressively declined as the number of treatment cycles increased. The number of embryos transferred increased with increasing number of treatment cycles. Implantation, pregnancy and clinical pregnancy rates decreased significantly with the second treatment cycle and more markedly with 3-5 treatment cycles.
  
  
  CONCLUSIONS
  The likelihood of a successful outcome declined with each additional treatment cycle. The most notable decrease in clinical pregnancy rates occurred after the third cycle. Patients who fail to conceive after 3 cycles of IVF should be counseled to begin considering other options.
authors.affiliation: Department of Obstetrics and Gynecology, Illinois Masonic Medical Center, Chicago, Illinois, USA.
authors.forename: Meredith K
authors.initials: MK
authors.lastname: Martin-Johnston
authors.forename: Meike L
authors.initials: ML
authors.lastname: Uhler
authors.forename: H Edward
authors.initials: HE
authors.lastname: Grotjan
authors.forename: Aaron S
authors.initials: AS
authors.lastname: Lifchez
authors.forename: Jane M
authors.initials: JM
authors.lastname: Nani
authors.forename: Angeline N
authors.initials: AN
authors.lastname: Beltsos
mesh_terms: D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D011247:Pregnancy; D018873:Pregnancy Rate; D019233:Retreatment; D012189:Retrospective Studies; D017211:Treatment Failure; D055815:Young Adult