Cumulative live birth rate and assisted reproduction: impact of female age and transfer day.
BACKGROUND
Many studies on assisted reproductive technology examine live birth rate per cycle. However, after a cycle fails, couples often want to know what their chances are of having a live birth if they continue treatment. From a patients' perspective, the cumulative probability of live birth is more informative.


METHODS
This study includes patients who underwent fresh, frozen and non-donor ICSI cycles at our IVF unit between 2006-2012. Patients were divided into two groups; Group 1 represented those who underwent only Day 5 transfers, Group 2 represented only Day 3 transfers. Patients who underwent both were excluded. -Cycles were analyzed until the first live birth or the end of the 3rd cycle. Using Kaplan-Meier analysis, we estimated the cumulative live birth rates for each group and according to female age.


RESULTS
The mean age for Group 1 was significantly lower than for Group 2. After 3 cycles, Group 1's CLBR was 79% versus 66% in Group 2. When analyzing the live births by age and group, there was a significant difference in the CLBR after 3 cycles with the women less than 35 years having the highest CLBR and the women 40 years or older having the lowest CLBR.


CONCLUSIONS
In women less than 35 years, excellent CLBR can be achieved irrespective of the transfer day. For women 40 years and above, better results of CLBR are observed with Day 5 transfers. Our findings may impact the counseling of couples considering IVF treatment.
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Hurley Medical Center, Flint, Michigan, United States, 48503. ; IVF Michigan, PC, Rochester Hills, Michigan, United States, 48307.
M I
MI
Abuzeid
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Hurley Medical Center, Flint, Michigan, United States, 48503.
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O
Bolonduro
Research Department, Hurley Medical Center, Flint, Michigan, United States, 48503.
J
J
La Chance
IVF Michigan, PC, Rochester Hills, Michigan, United States, 48307.
T
T
Abozaid
IVF Michigan, PC, Rochester Hills, Michigan, United States, 48307.
M
M
Urich
IVF Michigan, PC, Rochester Hills, Michigan, United States, 48307.
K
K
Ullah
IVF Michigan, PC, Rochester Hills, Michigan, United States, 48307.
T
T
Ali
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Hurley Medical Center, Flint, Michigan, United States, 48503. ; IVF Michigan, PC, Rochester Hills, Michigan, United States, 48307.
M
M
Ashraf
IVF Michigan, PC, Rochester Hills, Michigan, United States, 48307.
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I
Khan
ART; ICSI; IVF; cumulative live birth rate; female age; transfer day