Spontaneous pregnancies following discontinuation of IVF/ICSI treatment: an internet-based survey

Abstract

The objective was to determine the likelihood of conceiving spontaneously following cessation of IVF/ICSI; how long does it take and what factors are associated with conception? The design was an internet-based survey. All registered users of www.ivf-infertility.com received an electronic questionnaire addressing issues relating to the duration and cause of infertility, number of IVF/ICSI cycles and outcome, whether they conceived following cessation of IVF/ICSI and the time taken to conceive and outcome. Four hundred and eighty four patients responded of whom 403 met the study criteria. The overall cumulative live birth rate over a 6-year period following cessation of IVF/ICSI was 29%. Eighty-two percent of conceptions occurred within 2 years. Positive factors associated with spontaneous conception were unexplained infertility (p = 0.02), ovulation dysfunction (p = 0.01), infertility less than four years prior to IVF/ICSI (p = 0.045) and 2 years or less since discontinuation of IVF/ICSI (p < 0.001) and up to four attempts at IVF/ICSI (p = 0.02). In conclusion, 29% of couples conceived spontaneously over a 6-year period following the cessation of IVF/ICSI. The findings of this study can be used to counsel and reassure women following IVF/ICSI.

Probability of conception after fertility counseling and the association of sexually transmitted infections with pregnancy in the Loussi study.

“…Another study, which included 7 to 9 years of follow up time, reported a cumulative live birth rate of 17% after a prior successful IVF/ICSI [8]. Further, an internet survey study included varying times of follow up and reported 27.3% spontaneous conception rate after successful IVF/ICSI [7]. This particular study, however, may be an overestimation of the true rate, as those women who did conceive are conceivably more likely to respond to the online survey.…”

“…Few studies can be identified that assess spontaneous conception rates after failed ART treatments. The internet study mentioned previously also analyzed spontaneous conceptions among women who had unsuccessful IVF/ICSI treatments and decided to discontinue treatments [7]. The authors report that 35.4% of these women achieved spontaneous conception.…”

“…Unexplained infertility seems to be the best diagnosis for likelihood of conception. A retrospective internet survey study found that among women who had discontinued IVF/ICSI, those with unexplained infertility were 2.82 times more likely to spontaneously conceive than those with tubal damage (p = 0.005) [7]. Another study found that among infertile couples who remained untreated by ART, those with unexplained infertility were more than twice as likely to spontaneously conceive than those with tubal infertility (HR = 2.64, 95% CI: 1.75 -3.98) [59].…”

“…After discontinuation of ART, either successful or otherwise, or even if no ART was ever received, there is still a possibility that an infertile patient may have a spontaneous conception, meaning that the patient conceived on their own while not receiving any form of ART. Varying studies have found spontaneous conception rates after ART treatment to be anywhere from 17% to 34% [2][3][4][5][6][7][8].…”

“…These studies, however, vary in their defined population. For example, some studies [3][4][5][6] only include patients that had live births from IVF or ICSI, while others [7,8] include successful and unsuccessful treatments from ART, while still others only include those who had unsuccessful treatment [2] or a specific infertility diagnosis [9]. Fertility in women can be affected by the woman's history of a handful of STIs [10][11][12][13][14][15][16][17][18][19].…”