Second try who returns for additional assisted reproductive technology treatment and the effect of a prior assisted reproductive technology birth

Capsule:
Live-birth rates were significantly higher for try 2 compared with try 1 for autologous fresh cycles, averaging 7.7 percentage points higher over five cycles.

Authors:
Barbara Luke, Sc.D., M.P.H., Morton B. Brown, Ph.D., Ethan Wantman, M.B.A., Valerie L. Baker, M.D., Daniel R. Grow, M.D.

Volume 100, Issue 6, Pages 1580-1584, December 2013

Abstract:

Objective:
To evaluate the effect of a prior assisted reproductive technology (ART) live birth on subsequent live-birth rates.

Design:
Historical cohort study.

Setting:
Clinic-based data.

Patient(s):
The study population included 297,635 women with 549,278 cycles from 2004 to 2010 from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System. Try 1 refers to ART cycles up to and including the first live birth, try 2 to ART cycles after a first live birth.

Intervention(s):
None.

Main Outcome Measure(s):
Live-birth rates by cycle number, try number, and oocyte source.

Result(s):
Younger women at try 1 are more likely to return for try 2. Women returning for try 2 were more likely to have had an ART singleton versus multiple birth (33.2% after a try 1 singleton versus 8.1% after twins and 4.9% after triplets) and were less likely to have a diagnosis of diminished ovarian reserve or tubal factors. Live-birth rates were significantly higher for try 2 compared with try 1 for autologous fresh cycles, averaging 7.7 percentage points higher over five cycles. Live-birth rates were not significantly different for try 2 versus try 1 with thawed autologous cycles or either fresh or thawed donor cycles.

Conclusion(s):
These results indicate that when fresh autologous oocytes can be used, live-birth rates per cycle are significantly greater after a prior history of an ART live birth.

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