New York IVF Center Warns Against Oversimplification of Recent Statement 'IVF Success Rates Highest With 15 Eggs Retrieved'
NEW YORK, May 31, 2011 /PRNewswire/ -- A New York IVF center warns against simplistic interpretation of a recent report on IVF pregnancy rates, published online in the medical journal Human Reproduction. The paper(1) reported that maximal birth rates were achieved when 15 to 20 oocytes (eggs) were retrieved in an IVF cycle. A press release(2) by the European Society for Human Reproduction and Embryology (ESHRE), which publishes the journal, summarized the study as demonstrating that "15 [eggs] is the perfect number" to strive for in every IVF cycle, and many media outlets have followed. However, according to the fertility researchers at Center for Human Reproduction (CHR) in New York, NY, this conclusion is an oversimplification of reported data on IVF success rates.
"Assuming that patients receive reasonable ovarian stimulation for IVF," explains Norbert Gleicher, MD, Medical Director of CHR, "the number of retrieved eggs is only a reflection of the patients' ovarian reserve." Ovarian reserve is a medical term that describes a woman's current level of ovarian function. The study, showing that live birth rates plateaued between 15 and 20 eggs, only demonstrates that retrieval of 15 to 20 eggs reflects the maximal ovarian reserve at all ages.
According to research at CHR, ovarian reserve is also reflected in anti-Muellerian hormone (AMH) levels. In a paper(3) published in the medical journal Fertility & Sterility, CHR's IVF specialists reported last year that AMH above 1.05 ng/mL offers best live birth chances at all ages. The Human Reproduction study confirms the previous CHR finding that threshold levels of ovarian reserve, offering best IVF live birth rates, remain constant at all ages.
"Technically, ovaries cannot be stimulated toward production of a specific number of eggs," adds David H. Barad, MD, Clinical Director of IVF at CHR. "If the number of eggs, instead of ovarian reserve, were the true determinant of live birth chances, we could simply stop retrieving eggs when we reach that specified number. This, however, would only increase risks to patients. Perfect oocyte numbers, therefore, cannot really be acted upon."
Dr. Gleicher also warns that patients should not be misled into believing that every patient undergoing IVF can or should be stimulated toward the production of 15 to 20 eggs. Very few women above age 40, for example, can ever reach this range, even with maximal ovarian stimulation. Young women with polycystic ovary syndrome (PCOS), on the other hand, will often exceed this range, even with the mildest stimulation. "It is not the number of eggs we worry about," says Dr. Gleicher. "It's the patient's ovarian reserve!"
Center for Human Reproduction (http://www.centerforhumanreprod.com) is a leading IVF center in New York City with worldwide clientele, well-recognized for its major clinical research program, which over the years contributed a number of essential breakthroughs to the IVF process. Dr. Gleicher and Dr. Barad are available for further comments.
(1) Sunkara et al., Association between the number of eggs and live birth in IVF treatment: an analysis of 400,135 treatment cycles
(3) Gleicher et al., Anti-Muellerian hormone (AMH) defines, independent of age, low versus good live-birth chances in women with severely diminished ovarian reserve. Fertil Steril 2010;94:2824-7
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SOURCE Center for Human Reproduction
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