2ND TIME AROUND - A STUDY OF PATIENTS SEEKING 2ND ASSISTED REPRODUCTION PREGNANCIES

Objective: To investigate the outcomes of subsequent cycles of IVF-ET, GIFT, and frozen ET in patients who have already achieved at least one assisted reproductive technology (ART) pregnancy. Design: Retrospective cohort. Setting: Private infertility clinic, Brisbane, Queensland, Australia. Patients: From 1985 to 1992, 4,860 patients underwent 13,106 ART oocyte retrieval cycles. One thousand nine hundred twenty-two patients achieved a pregnancy, and 784 returned for a second pregnancy. These 784 return patients were divided into two subgroups: group A (288 patients) took home at least one baby from their first pregnancy; group B (496 patients) had an unsuccessful first pregnancy. Main Outcome Measures: Pregnancy rate (PR), cumulative PR, pregnancy outcome. Results: Patients returning for second and third ART pregnancies had an increased chance of success. Pregnancy rates increased from 31.0% per transfer for patients attempting their first GIFT pregnancy, to 34.7% and 42.7% per transfer for patients attempting their second and third GIFT pregnancy. Cumulative PRs increased with subsequent pregnancy attempts. Groups A and B did not differ in PR, age, or indication of infertility but had significantly different live birth rates. The pregnancy outcomes of frozen ETs depended on the outcomes of the original cycle from which the embryos were derived. Conclusions: This study has important implications for the counseling of patients returning for subsequent ART pregnancies.