If you’re wondering - and hoping - your future might include babies and you’ve been thinking it might be time to talk about in vitro fertilization (IVF), at least two online tools can help assess your individual chances of getting pregnant with treatment. The reasons for infertility vary widely and it can sometimes be difficult to estimate chances of pregnancy, especially before the first cycle which provides information about the quality of eggs, sperm, and embryos.
Both patient predictor tools - one released last year in the US and one just launched in the UK are designed to provide additional information to couples considering IVF treatment, along with consulting a fertility specialist. Each uses your unique information on factors known to affect fertility, sophisticated algorithms and extensive databases on the experiences of women who became pregnant using IVF. The resulting estimate can help you understand whether IVF might be an option by predicting a rate of success after each cycle.
A major goal of new patient predictors is to help couples “be better informed and help them prepare emotionally and financially for their treatments” states UK researcher David McLernon, who developed the UK calculator. Estimates of how many cycles might be needed can help couples better predict treatment costs as IVF is often not covered by insurance. McLernon adds clinicians, funders, and policymakers might also learn from the new predictive tools.
The UK launch follows the release last year of the Patient Predictor from the Society for Reproductive Technology (SART). The SART data and models are very helpful because they demonstrate that success rates with IVF can be quite high, but some women will need to undertake more than one cycle, and not all women become pregnant.
The online tools estimate individual chances of IVF success by asking you to answer questions - most of which you can easily do on your own including age, height, weight and whether you’ve been pregnant and/or delivered babies and if so, how many times. Additional questions may require information from your doctor including the diagnosis of the reasons for your infertility and whether you plan to use your own eggs or donor eggs. And, the tool assumes you have not previously had IVF treatment.
While both patient calculators are designed to do the same thing, there are differences. The UK tool is the first to give estimates for success for up to six cycles - important as multiple cycles are often required to get pregnant. The current SART model - used by many doctors - makes estimates for up to three cycles. The UK version also factors in the use of frozen embryos while the current SART model is based on sequential transfer of fresh embryos. The SART predictor does factor in multiple transfer of embryos and the probability of twins and the UK model does not. And, the SART version leverages their extensive database of patient infertility treatment and outcomes more than twice the size of the UK version - nearly 500,000 cycles for 320,000 women vs. 189,269 cycles for 115,000 women.
No matter which calculator you choose, these are exciting advances for couples considering IVF. The UK researchers do offer an important caveat - the new tools can’t address every single factor that influences whether a treatment cycle for an individual patient will result in a healthy baby. In fact, McLernon’s calculator was not able to take into account factors known to affect fertility, including a woman’s BMI and ethnicity, plus alcohol consumption and whether she smokes.
Others agree with the caution, adding patients must realize these are only an estimate and additional factors not included in the model could influence the outcome. Certainly, as we learn more about infertility, future models will include new factors.
These new tools can help you better understand your chances of success using IVF but are not a substitute for working with your infertility specialist for a full diagnosis and discussing all your options.
For now, think of using these new tools as part of a first step on your way to baby steps.