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    Less Aggressive IVF Treats Infertility

    Live Birth Rate Similar Over Time With 1 Embryo Transfer, With Fewer Multiple Births

    IVF Lite continued...

    Only one multiple birth occurred among the 92 women who delivered after getting the milder version of IVF, compared to 26 multiple births among 102 women who gave birth after traditional IVF.

    The findings about the per cycle success rate with single-embryo, less aggressive treatment has been reported in previous studies.

    But the researchers argue that the similar success rate over time, coupled with a dramatically reduced risk of multiple births, and lower overall costs due to fewer multiple pregnancies, makes the less aggressive approach the better option for infertile women with a good chance of achieving a live birth with treatment.

    The study is reported in the March 3 issue of the The Lancet.

    “Our findings should encourage more widespread use of mild ovarian stimulation and single embryo transfer in clinical practice,” the researchers write.

    “However, adoption of our mild IVF treatment strategy would need to be supported by counseling of both patients and health care providers to redefine IVF success and explain the risks associated with multiple pregnancies, and by [supporting payment plans] that encourage, rather than penalize, the practice of single embryo transfer,” the researchers say.

    Patient Resistance

    In the U.S., only a handful of states mandate coverage for infertility treatment, meaning the vast majority of infertile couples pay for such treatments out-of-pocket.

    Because per cycle costs are so steep, infertile couples seeking treatment have traditionally been willing to accept the risk of multiple births in order to maximize their chances of success in one try.

    The American Society for Reproductive Medicine (ASRM) recommends that no more than two embryos be transferred per cycle in women who are 37 or younger with a good chance of achieving success with IVF.

    ASRM president Steven Ory, MD, tells WebMD that single-embryo transfers are increasingly being performed, but there is still far to go.

    Ory says whether patients are footing the bill or not, they tend to believe that their chance of success is strongly tied to the number of embryos transferred.

    “The biggest complication of IVF is the high multiple pregnancy rate, and we are working very, very hard to get that down,” he says. “We regard single-embryo transfer as the ideal for women with a good chance of achieving a pregnancy.”

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