Cumulative probability of live birth after three in vitro fertilization/intracytoplasmic sperm injection cycles

Objective: To assess the probability of live birth after three available in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles. Design: Retrospective, observational study. Setting: University hospital. Patient(s): Nine hundred seventy-four couples who started their first conventional IVF or ICSI cycle between January 1996 and December 1997, A total of 1985 stimulated cycles were initiated. Intervention(s): Analysis of the cumulative live birth rate using the life-table approach with and without taking dropouts into account. Main Outcome Measure(s): Cumulative live birth rate. Result(s): The overall cumulative live birth rate after three completed stimulated cycles (including freezing/ thawing cycles) was 65.5% with an "optimistic" approach. For the "realistic" and "pessimistic" approaches the corresponding figures were 63.1% and 55.5%, respectively. Unexpectedly, 65% of couples not achieving a live birth interrupted the full treatment program of three cycles. Conclusion(s): The cumulative live birth rate gives the couple a more accurate prognosis of achieving a live birth after IVF/ICSI than the statistics usually provided. With the "realistic" estimation, 63% of the couples achieved childbirth after three available conventional IVF or ICSI cycles. Further studies are required to investigate the high drop-out rate. (Fertil Sterl((R)) 2002;77:505-10. (C) 2002 by American Society for Reproductive Medicine).