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Another possible limitation of the study, the authors say, is the fact that all patients seeking infertility treatment in the state of Massachusetts are at least partially reimbursed by their health-insurance carriers, by law. IVF can cost up to $10,000 or more per cycle, and the study group at the Massachusetts clinic likely included many patients less deterred by financial issues than women in the general population, possibly distorting the data. Malizia, who now serves as a reproductive endocrinologist at Alabama Fertility Specialists in Birmingham, Ala., suggests, however, that the live-birth rates of her study group skewed...
...study's more than 6,000 participants became pregnant and gave birth, or underwent the full six cycles of IVF before leaving the clinic, which accounts for the range of live-birth rates. Researchers had to extrapolate from their existing data the likely outcomes for patients who discontinued treatment: In the "optimistic" analysis, researchers assumed that the women who discontinued treatment would have had the same success rates as those who continued treatment; the "conservative" analysis assumes a zero success rate among all women who discontinued IVF at that particular clinic. Realistically, say the authors, the actual live-birth rates...
Malizia's study may not break new medical ground, but it presents a new perspective on IVF, in that most studies that analyze the treatment's success rates look solely at the outcomes of individual implantations, not the overall possibility of a live birth. "As far as the patients are concerned, they would like to know not just pregnancy but live birth [outcomes], and not just during that one cycle but over the course of the entire treatment," Malizia says. "The statistics that are out there don't exactly answer the question...
...Centers for Disease Control and Prevention collects national statistics on success rates for assisted reproductive technology, but that data, too, is broken down by individual cycles of IVF; the data in the new study calculated the overall likelihood of a live birth during the entire course of treatment - up to six cycles of IVF. The study also incorporated data for all patients who sought treatment at the Massachusetts center, regardless of age or potential for pregnancy complications. In addition, the data accounted for success rates of IVF using frozen embryos; other analyses typically consider only "fresh" embryo...
...Malizia, that was precisely the goal. "My hope would be that physicians around the country would use this information in counseling patients," she says, in turn arming those patients with more information to make wiser decisions about treatment...