London - Couples with fertility problems who turn to IVF should persist even if their first attempts to have a baby fail, experts have advised.
By the sixth cycle, women have a 65 percent chance of becoming mothers, according to a major study.
Although the first cycle ends in heartbreak for most couples, their chances of having a child rises the more times they try. Despite this, nearly half of couples – 43 percent – who fail at the first go never try again, according to analysis of eight years of British records.
This may be because the NHS will not fund a second attempt and they cannot afford to go private.
NHS watchdog Nice advises that women under 40 should be offered three IVF cycles if they have not conceived naturally after two years.
But the guidance is not mandatory so standards differ wildly across the country. Fewer than one in five health boards offers couples the recommended three cycles while some offer just one.
The team from Glasgow and Bristol Universities also suggested the number of IVF cycles per patient should continue beyond three. But their data suggests that few couples even get that far, with just 15 percent who started IVF reaching the three full cycles.
The academics analysed the records of all women who had fertility treatments in Britain between January 2003 and December 2010.
They found the cumulative chance of a live birth was 30 percent for the first cycle, 45 percent after two and 54 percent after three.
There was a 65 percent success rate after six attempts and then the chance of a baby plateaued with subsequent cycles.
Some couples in the study had tried nine times, by which time the success rate had risen to 69 percent.
“Fertility treatments are being stopped prematurely,” said study author Professor Scott Nelson,a fertility expert at London’s Royal Infirmary.
“They should keep going. We need to stop thinking of IVF as a single shot at having a family and think of several cycles as the standard.
“For most couples, and certainly those where the woman is younger than 40 and those of any age using donor eggs, two-thirds will achieve a live birth after five or six cycles.
“This will take on average two years and is similar to rates that couples conceiving naturally take in one year. Clinical commissioning groups should be funding at least three cycles across the board – just look at the impact they can have for families.”
Co-author Professor Debbie Lawlor, of the University of Bristol, said: “Clinicians often dissuade couples from further cycles when they have had one with no eggs retrieved or imply results from one such cycle indicate very low chance of future success. Our results suggest that is not the case.”
Stuart Lavery, a fertility expert at Imperial College London, commented: “This report emphasises couples should view IVF as a course of treatments, not an one-shot opportunity.
“This should mirror trying to conceive naturally – couples understand instinctively that it may take more than one month and understand the need for perseverance.”
He added that stress was the main reason for couples stopping IVF. He urged clinics to ease the pressure of treatment with “shorter protocols, lower side-effects, and reduced costs’”
The study published in the JAMA medical journal covered 156 947 women in the UK who received 257 398 IVF ovarian stimulation cycles.
Daily Mail