From Egg to Offspring. Survival Rates in In-Vitro Fertilisation: Where Does it Go Wrong?
Introduction
(wz) The first attempts at IVF used natural cycles. It was soon surmised that in order to attain acceptable pregnancy rates, a sufficient quantity of eggs for insemination was necessary to enable choice in numbers and quality of embryos for transfer. But, this is undoubtably wasteful and costly. While natural cycle IVF with results running at 7% still does not appear to be the answer1 such a situation should not continue unquestioned.
Medical and psycho-social problems with multiple embryo transfer have led to increasing calls for single embryo transfer.2 Additionally, many frozen embryos surplus to the initial fresh cycle transfer requirements remain in storage. While this can have considerable advantages for the future, some may remain cryopreserved unused and unwanted. This may be due to breakdown in a relationship. It can also occur following previous success when a family is deemed complete. Both situations can lead to difficulty as to what to do.3
This study looks at our practice to estimate what survival rates are likely to be when the various stages of development from egg through to birth are reached. Calculating these will give insight into where the greatest waste occurs to see the optimal direction towards which future cost-effective improvements should be aimed.
Methods
The study data involves 2,927 IVF cycles, both fresh and frozen, carried out from 2001-4 inclusively at the Rotunda Hospital Human Assisted Reproduction Ireland Unit [HARI]. All these were then followed through to the end of the first week of life. All information was retrieved retrospectively from the computerised data set and manual log kept on all patients.There was a 100% pregnancy follow up attained by correspondence backed up by personal communication as not all pregnancies were managed at the Hospital. more…
From: »Irish Medical Journal«