Poor Responder? Failed IVF? Abnormal Ovarian Reserve?

At IVF Phoenix, 88% of patients who follow our recommendations,
deliver a baby. Out of that number, only 1 in 5 (20%)
patients used IVF to achieve this goal.

Contrast this with published overall prognosis with current treatment of infertility.
Without high tech IVF, 37% of infertility patients will deliver a baby.
By applying IVF to 50% of those unsuccessful patients,
only 47% will deliver a baby..

(Phoenix, AZ) Most fertility centers will extol their IVF success rates, and outcomes, to imply that improved IVF success rate equates with a improved overall success. In a review of IVF success rates over the years, there has been significant improvement but, the rates have been plateauing. Comparing U.S. ART cycles from 1996 and 2003, there is a 47% increase in the number of ART cycles done, but only a 7% increase in the live birth rates.

In reviewing delivery rates per ET, locally and nationally, we can determine some invariance. Data from two very large ART groups, historically known to have high rates shows that 44/36/25 plateaued data from 2003 and 2004. At IVF Phoenix, we have operated at this level of success, even while we have been looking for more appropriate and specific ways to get your patients pregnant, without resorting to the big gun, IVF. At IVF Phoenix, we are getting better at culling out the nonessential IVF cases and still getting them to conceive, and we still maintain historically high ART rates with the more complex cases. We must be doing most things right at IVF Phoenix.

With centers reporting 55% delivery rates, specifically for the <35 year old woman, these numbers are out of norm. Aside from assuming that they are doing a better job with their handling of IVF, what else could account for the numbers. There may be statistical variation making the numbers high temporarily. There may be cherry picking, where difficult cases are refused in order to optimize the outcomes. There may be stacking, where non-essential IVF cases are sent into IVF. What we do not know is what is the success rate for IVF on healthy not infertile humans. In a virus-free bovine population, this rate is around 75% delivery rate per embryo transfer. This represents the limits of success for ART with our current technology. But IVF is not supposed to be done on patients who can get pregnant with simpler means.

There is a difference in fecundity rates in humans. We have been taught that the fecundity rate is 10-20% per cycle. We have been told that with unexplained infertility, the chance of getting pregnant per cycle is 1-2%. Adding clomid moves the success to 4%. Doing timed IUI alone is 3%. Blending clomid and timed IUI is 7%. Doing clomid and HMG with IUI is 14-17%, and doing IVF was 25%, and currently varies depending on the age group. In a little known study, 50 couples who were known to be able to conceive, were subjected to tightly timed IC or IUI. In the first attempt, 75% of those fertile patient conceived. By the third cycle, 88%, and after 6 cycles, all 100% had conceived.

At IVF Phoenix, our cutting edge approach provides greater reproductive efficiency, and better financial economy. But the referring doctors continue to send patients to the other centers that make IVF their greatest focus.

The goal is not to use IVF to get a baby, the goal is to get a baby the most efficient way possible.

INTERVIEW OPPORTUNITY:

Dr. Couvaras is available to speak specifically about unexplained infertility and the treatments he recommends precede IVF, including:

• Failed IVF, What’s next?
• The definition of unexplained infertility
• Innocuous conditions that have shown links to infertility
• Unorthodox approaches to stimulating fertility in so-called unexplained cases

Dr. Couvaras is board certified in reproductive endocrinology, obstetrics and gynecology and an active member of the American Society of Reproductive Medicine. He is the director of Reproductive Endocrinology and Assisted Reproductive Medicine and past chairman of the Department of Obstetrics and Gynecology at Paradise Valley Hospital. He is certified in CO2 and YAG laser surgery, operative laparoscopy and hysteroscopy, and microsurgical tubal and pelvic surgery. His expertise includes all aspects of female reproductive medicine and surgery.