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Factors affecting IVF success rateCharacteristics of the couples seeking IVF treatmentThere are many factors that may affect the outcome of IVF treatment. These may include one of the following characteristics of the couples seeking IVF treatment. The age of the womanThe age of the woman has a significant affect on her fertility and the live birth rate decreases significantly from the age 35 years when the woman is using her own eggs. The older the woman, the higher the chance of cancellation, the lower the chance of success and the higher chance of miscarriage and chromosomal abnormalities. In the USA the live birth rate of women aged 41 and over was 7.1% per cycle initiated. 
Data adapted from SART report 2002
Data adapted from SART report 2002 Use of donated eggs, donor embryos or donor spermThe highest live birth rates are found among women who have had IVF with donated eggs, donor sperm or donated embryos. Live birth rate per cycle in couples who have had IVF with their eggs and sperms compared with IVF using donor sperm, donated eggs and donated embryos. The overall delivery rate per transfer following the use of donor eggs was 41.2% compared to 31.1% following IVF using own eggs (data from SART report 2002).
Data adapted from HFEA Report 1997 Number of embryos transferredIn general, the higher the number of embryos transferred, the greatest the chance of success. In the UK a maximum number of embryos to be transferred per treatment cycle is three. There is trend to transfer only two embryos especially in younger women to reduce the risk of multiple pregnancies.
Data adapted from HFEA Report 1997 There is some evidence that the live birth rates for treatment where two embryos are transferred (provided that more than four embryos were created) is almost identical to the live birth rate for treatments where three embryos are transferred but with a lower multiple pregnancy rate.
Data adapted from HFEA Report 1998 Women aged 40 years and older: Transfer of two embryos is recommended if using donated eggs. However if using their own eggs, then the transfer of three or four embryos (if allowed) is advised because both the chance of success and multiple pregnancy are lower when using own eggs compared to donated eggs. Duration of infertilityThe longer the couple has been infertile, the lower the chance of success.
Data adapted from HFEA Report 1999 Cause of infertilityOutcome of IVF treatment varies with the cause of infertility.
Data adapted from HFEA Report 1997 Number of previous IVF treatment cyclesLive birth rates is highest in the first cycle (17.4%) and drop to 14.4% by the fifth cycle (HFEA Report 1999). Although cycles 6-8 appear to give a reasonable chance of success, few patients persevere that long.
Data adapted from SART report 2002 Previous pregnancy and live birthWoman, who has been pregnant before or has had a previous IVF birth, has a higher chance of success than woman who has never been pregnant. The relation between previous pregnancy and live birth and the live birth rate per treatment cycle.
Data adapted from HFEA Report 1998. The presence of hydrosalpingesThere is increasing evidence that the presence of hydrosalpinges adversely affects the live birth rates of women undergoing IVF treatment. The mechanism for reduced implantation in women with hydrosalpinges is not fully understood but it is possible that the leakage of the fluid from the tube into the womb wash off the embryos, or the fluid itself could have toxic effects on the embryos. Most specialists offer surgical treatment for hydrosalpinges before IVF treatment. The treatment usually inviolves removal of the tube (salpingectomy) preferably by laparoscope. An alternative is to occlude the tube at its uterine end again by laparoscopy or aspiration of the fluid from the tube. A recent Cochrane Database Review has demonstrated the efficacy of laparoscopic salpingectomy in improving live birth rates in women with hydrosalpinges due to undergo IVF treatment. NICE Fertility Guidelines in the UK advocates that women with hydrosalpinges should be offered salpingectomy, preferably by laparoscopy, before IVF treatment. Basal FSH and LH levels (ovarian reserve)Woman with a base FSH level of 12 or more IU/L or FSH/LH ratio more than 3 or women with an Inhibin level less than 80 pg/ml are unlikely to respond adequately to ovarian stimulation. Uterine fibroidsFibroid that compress the cavity of the womb significantly reduce live birth rate (Hart et al 2001 Human Reproduction). LifestyleObese women take longer to conceive and are at higher risk of miscarriage than normal weight women.(Linsten et al 2005 Human Reproduction; Fedorcsak et al (2004) Human Reproduction). Smoking reduce implantation and pregnancy rates (Neal et al, 2005,. Human Reproduction). Smoking also adversely affects live birth rates equivalent to increased female age by 10 years (Linsten et al, 2005. Human Reproduction)
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