Evolution of cumulative live birth and dropout rates over six complete IVF/ICSI cycles: a large prospective cohort study

Diane De Neubourg, Kris Bogaerts, Elisabeth Anagnostou, Candice Autin, Christophe Blockeel, Tom Coetsier, Anne Delbaere, Nicolas Gillain, Frank Vandekerckhove, Christine Wyns

Research output: Contribution to journalArticle

Abstract

RESEARCH QUESTION: How do cumulative live birth rates (CLBR), cumulative multiple live birth rates (CMLBR) and dropout rates over six IVF and intracytoplasmic sperm injection (ICSI) cycles change over time?

DESIGN: Prospective longitudinal cohort (n = 16,073 patients; 48,946 cycles) starting a first fresh assisted reproductive technology cycle between 1 January 2014 and 31 December 2016, with follow-up until 31 December 2017. Outcomes between the periods 2014-2017 and 2009-2012 were compared.

RESULTS: Conservative estimates of CLBR after six complete cycles were significantly higher in women younger than 35 years after every cycle: one to three, adjusted P-value [p adj] < 0.0001; four, p = 0.01; five, p adj = 0.03; six, p adj = 0.04) and after the first cycle in women aged 35-37 years (p adj = 0.04) in 2014-2017 versus 2009-2012. For an optimal estimate, the CLBR was significantly higher after the first three cycles in women younger than 35 years (all p adj < 0.0001) and after the first cycle in women aged 35-37 years (p adj = 0.04). The CMLBR rate decreased from 5.1% ± 0.19 (SE) to 4.1% ± 0.16 for the conservative estimate and from 8.6% ±0.37 (SE) to 6.7% ± 0.30 for the optimal estimate after six complete cycles for the whole cohort. Dropout rates of complete cycles were 26.5% 29.4%, 33.4%, 38.9% and 47.3% after the first to fifth cycle, respectively. Compared with 2009-2012, the dropout rate in the current period was significantly higher for the first (P < 0.0001) and second (P = 0.0124) cycle.

CONCLUSION: Over six complete IVF/ICSI cycles, CLBR and dropout rates increased and multiple live birth rates decreased when 2014-2017 was compared with 2009-2012.

Original languageEnglish
Pages (from-to)717-724
Number of pages8
JournalReproductive Biomedicine Online
Volume42
Issue number4
Early online date16 Jan 2021
DOIs
Publication statusPublished - Apr 2021

Bibliographical note

Copyright © 2021 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Keywords

  • Cumulative live birth rate
  • Cumulative multiple live birth rate
  • Discontinuation
  • Drop-out rate
  • IVF/ICSI

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