Should there be a/ny limit to IVF cycles? A rejoinder to Stewart et al.

6 09 2011

In a recent paper, Stewart et al. (1) report the probability of a live delivery over real time in a population-based cohort of women undergoing in vitro fertilization (IVF) treatment at clinics in Western Australia. They suggested that women should persevere in IVF treatment. However, they did not mention any limit on IVF cycles. Moreover, in the report by Stewart et al., the success rate of live deliveries reaches a plateau (meaning zero new deliveries) long before the 180 months and the number of cycles for which they had data. This means that women may continue with IVF treatment even when the probability of a successful outcome is “zero,” which begs the question of whether there should be any limit on IVF cycles. Undoubtedly, IVF has been a milestone in reproductive medicine, as millions of babies (five million up to 2006) have already been born with the aid of IVF. However, many questions about IVF still remain (2). One of these questions is the effect/s of long-term IVF treatment on women (3). Read the rest of this entry »

How effective is in vitro fertilization, and how can it be improved?

8 03 2011

To the Editor:

We would like to thank Dr. Stewart et al. for the fine article (1). The aim of the study was to determine in vitro fertilization (IVF) effectiveness in women undergoing IVF treatment at clinics in Western Australia between 1982-1992 and 1993-2002. They suggested that IVF effectiveness could be improved particularly in women over 35 who underwent more cycles. Read the rest of this entry »

Less may, indeed, be less: multi-collinearity in studies of ovarian reserve

30 10 2008

To the Editor:

We read with interest the recent paper by Pal et al. (1), in which they conclude that their data and accruing literature suggest adverse influences of “excess” gonadotropin use on IVF outcomes. While we applaud their attempt at tackling a potentially very important question, we disagree with interpretation of data and conclusions in the manuscript. Read the rest of this entry »