Just 18% of IVF cycles in Australia and New Zealand result in a live birth, a report led by fertility experts has found.

Of the 81,062 initiated IVF cycles in 2016-17, 66,664 (82.2%) resulted in either a successful embryo transfer, or all oocytes/embryos being preserved at subzero temperatures for use in IVF, known as cryopreservation.

But there are several steps to successfully get through in an IVF cycle before getting to the embryo transfer stage, including hormone treatments to stimulate the ovaries, egg retrieval and fertilisation. If an IVF cycle resulted in a successful embryo transfer, the chance of a live birth increased to 26.2%.

The report, published on Sunday by the University of New South Wales, found that 15,198 babies were born in Australia and New Zealand in 2016-17 as a result of cycles begun in 2016. Despite 82% of IVF cycles failing, the data shows the highest number of births in IVF’s 40-year history.

In 2012 less than a quarter of embryo transfers resulted in a live birth. This increased to just over 26% in 2016-17, largely because of an increase in the success rate of frozen embryo transfers, from 20% in 2012 to 27% in 2016. For the first time, there were more thawed embryo transfer cycles than fresh cycles performed in 2016 – almost 60% of babies born through IVF treatment who came from frozen embryos.

The proportion of IVF cycles resulting in twins and triplets is now 3.8%, one of the lowest rates in the world.

Owing to a continued trend of delaying childbirth, one in four IVF cycles are performed in women aged 40 years or over. Success rates are much lower in this age. But there was a slight increase in success for this group over the last five years, from 10% in 2012 to 13% in 2017.

“There was a higher live delivery rate in younger women,” the report found. “For women aged under 30, the live delivery rate per embryo transfer was 36.9% for autologous fresh cycles and 33.3% for autologous thaw cycles,” the report found. “For women aged over 44, the live delivery rate per cycle was 1.3%, and 11.8% per embryo transfer.”

In 10.7% of cases, male infertility factors were reported as the only cause of infertility; 31.3% reported only female infertility factors; 12.2% reported combined male–female factors; 21% reported unexplained infertility; and in 24.8% of cases the reasons for infertility were not stated.

The average age of women having IVF treatment in 2016 was 36 years.

The report comes as the Victorian government in April announced a review into the state’s IVF laws to ensure women were getting accurate information from IVF and fertility doctors about success rates and treatment options. Each cycle is costly, with IVF Australia figures showing patients are out of pocket an average $4,707 for their first IVF cycle and $4,151 for subsequent cycles.

The review is being led by the medical lawyer Michael Gorton, and part of his role will be to consider whether there are adequate safeguards to protect consumers using or intending to use assisted reproductive treatment services.

Australia’s IVF success rates are similar to those of the UK. According to the UK’s National Health Service, between 2014 and 2016 the percentage of IVF treatments that resulted in a live birth was 29% for women under 35, 23% for women aged 35 to 37, 3% for women aged 43 to 44 and about 2% for women aged over 44.

Success rates can also vary according to legislation. For example, in China some advanced procedures are prohibited, with freezing eggs banned unless a woman is married or has certain diseases preventing pregnancy.

Dr Karin Hammarberg, a senior research fellow at Monash University’s school of public health & preventive medicine, said IVF success rates were slightly higher in the US than in Australia because there was an “enormous” rate of multiple births there.

“They put back more embryos than we do, but we know multiple births have more risks and can have worse outcomes and complications for mother and child,” she said.

Hammarberg said the way IVF success rates were communicated on the websites of fertility clinics could be misleading.

“If you look at how rates are reported on IVF clinic websites it is not transparent at all as it talks about live births per pregnancy or per embryo transfer, and that doesn’t count all those whose cycles didn’t even result in an embryo transfer, or those pregnancies that don’t go to term,” she said.

“You need to talk about live births per started cycle, and so 80% of started cycles are not going to generate a baby and that’s what people need to know. And it will usually take multiple cycles to before a pregnancy results.”







