Pregnancy rate is the success rate for getting pregnant. It is the percentage of all attempts that leads to pregnancy, with attempts generally referring to menstrual cycles where insemination or any artificial equivalent is used, which may be simple artificial insemination (AI) or AI with additional in vitro fertilization (IVF).
There is no universally accepted definition of the term. Thus in IVF pregnancy rates may be based on initiated treatment cycles, cycles that underwent oocyte retrieval, or cycles where an embryo transfer was performed. In terms of outcome, "pregnancy" may refer to a positive pregnancy test, evidence of a pregnancy with a "viable" fetus or implantation. Furthermore, pregnancy rates can be influenced in IVF by transferring multiple embryos that may result in multiple births. A strict definition in the IVF setting would refer to the singleton pregnancy rate that determines how many live singletons are born in relation to initiated IVF cycles.
In some cases, success rates include delivery or presence of a live baby (preferably specified as delivery rate or live birth rate respectively).
In IVF or its derivatives, fertilization rate may be used to measure how many oocytes become fertilized by sperm cells. A fertilization rate of zero in one cycle, where no oocytes become fertilized, is termed a total fertilization failure. [1] Repeated ICSI treatment may be useful or necessary in couples with total fertilization failure. [1]
Implantation rate is the percentage of embryos which successfully undergo implantation compared to the number of embryos transferred in a given period. In practice, it is generally calculated as the number of intrauterine gestational sacs observed by transvaginal ultrasonography divided by the number of transferred embryos. [2] As an example, one center in the United States reported an implantation rate in IVF of 37% at a maternal age of less than 35 years, 30% at 35 to 37 years, 22% at 38 to 40 years, and 12% at 41 to 42 years. [3]
Successful implantation of the zygote into the uterus is most likely 8 to 10 days after conception. If the zygote has not implanted by day 10, implantation becomes increasingly unlikely in subsequent days. [4]
Live birth rate is the percentage of all cycles that lead to live birth, and is the pregnancy rate adjusted for miscarriages and stillbirths. For instance, in 2007, Canadian clinics reported a live birth rate of 27% with in vitro fertilisation. [5]
There is a substantial connection between age and female fertility. Menarche, the first menstrual period, usually occurs around 12–13, although it may happen earlier or later, depending on each girl. After puberty, female fertility increases and then decreases, with advanced maternal age causing an increased risk of female infertility.
A 2001 review suggested a paternal age effect on fertility, where older men have decreased pregnancy rates. [7]
The time with the highest likelihood of pregnancy resulting from sexual intercourse covers the menstrual cycle time from some 5 days before until 1 to 2 days after ovulation. [10] In a 28‑day cycle with a 14‑day luteal phase, this corresponds to the second and the beginning of the third week. A variety of methods have been developed to help individual women estimate the relatively fertile and the relatively infertile days in the cycle; these systems are called fertility awareness.
There are many fertility testing methods, including urine test kits that detect the LH surge that occurs 24 to 36 hours before ovulation; these are known as ovulation predictor kits (OPKs). [11] Computerized devices that interpret basal body temperatures, urinary test results, or changes in saliva are called fertility monitors. Fertility awareness methods that rely on cycle length records alone are called calendar-based methods. [12] Methods that require observation of one or more of the three primary fertility signs (basal body temperature, cervical mucus, and cervical position) [13] are known as symptoms-based methods. [12]
For optimal pregnancy chance, there are recommendations of sexual intercourse every 1 or 2 days, [14] or every 2 or 3 days. [15] Studies have shown no significant difference between different sex positions and pregnancy rate, as long as it results in ejaculation into the vagina. [16] According to the American Pregnancy Association, the following factors of sexual intercourse may increase pregnancy chances:
Generally, the pregnancy rate for artificial insemination is 10–15% per menstrual cycle using ICI, [17] and 15–20% per cycle for IUI. [17]
With enhanced technology, the pregnancy rates are substantially higher today[ when? ] than a couple of years ago. In 2006, Canadian clinics reported an average pregnancy rate of 35%. [5]
Fertility awareness (FA) refers to a set of practices used to determine the fertile and infertile phases of a woman's menstrual cycle. Fertility awareness methods may be used to avoid pregnancy, to achieve pregnancy, or as a way to monitor gynecological health.
In vitro fertilisation (IVF) is a process of fertilisation where an egg is combined with sperm in vitro. The process involves monitoring and stimulating a woman's ovulatory process, removing an ovum or ova from her ovaries and letting sperm fertilise them in a culture medium in a laboratory. After the fertilised egg (zygote) undergoes embryo culture for 2–6 days, it is transferred by catheter into the uterus, with the intention of establishing a successful pregnancy.
Intracytoplasmic sperm injection is an in vitro fertilization (IVF) procedure in which a single sperm cell is injected directly into the cytoplasm of an egg. This technique is used in order to prepare the gametes for the obtention of embryos that may be transferred to a maternal uterus. With this method, the acrosome reaction is skipped.
Ovulation is the release of eggs from the ovaries. In women, this event occurs when the ovarian follicles rupture and release the secondary oocyte ovarian cells. After ovulation, during the luteal phase, the egg will be available to be fertilized by sperm. In addition, the uterine lining (endometrium) is thickened to be able to receive a fertilized egg. If no conception occurs, the uterine lining as well as the egg will be shed during menstruation.
Infertility is the inability of a person, animal or plant to reproduce by natural means. It is usually not the natural state of a healthy adult, except notably among certain eusocial species. It is the normal state of a human child or other young offspring, because they have not undergone puberty, which is the body's start of reproductive capacity.
Artificial insemination is the deliberate introduction of sperm into a female's cervix or uterine cavity for the purpose of achieving a pregnancy through in vivo fertilization by means other than sexual intercourse. It is a fertility treatment for humans, and is a common practice in animal breeding, including dairy cattle and pigs.
Assisted reproductive technology (ART) includes medical procedures used primarily to address infertility. This subject involves procedures such as in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), cryopreservation of gametes or embryos, and/or the use of fertility medication. When used to address infertility, ART may also be referred to as fertility treatment. ART mainly belongs to the field of reproductive endocrinology and infertility. Some forms of ART may be used with regard to fertile couples for genetic purpose. ART may also be used in surrogacy arrangements, although not all surrogacy arrangements involve ART. The existence of sterility will not always require ART to be the first option to consider, as there are occasions when its cause is a mild disorder that can be solved with more conventional treatments or with behaviors based on promoting health and reproductive habits.
Embryo transfer refers to a step in the process of assisted reproduction in which embryos are placed into the uterus of a female with the intent to establish a pregnancy. This technique (which is often used in connection with in vitro fertilization, may be used in humans or in other animals, in which situations the goals may vary.
Human fertilization is the union of a human egg and sperm, occurring primarily in the ampulla of the fallopian tube. The result of this union leads to the production of a fertilized egg called a zygote, initiating embryonic development. Scientists discovered the dynamics of human fertilization in the nineteenth century.
Human reproduction is sexual reproduction that results in human fertilization to produce a human offspring. It typically involves sexual intercourse between a sexually mature human male and female. During sexual intercourse, the interaction between the male and female reproductive systems results in fertilization of the ovum by the sperm to form a zygote. These specialized reproductive cells are called gametes, which are created in a process called gametogenesis. While normal cells contain 46 chromosomes, gamete cells only contain 23 single chromosomes, and it is when these two cells merge into one zygote cell that genetic recombination occurs and the new zygote contains 23 chromosomes from each parent, giving it 46 chromosomes. The zygote then undergoes a defined development process that is known as human embryogenesis, and this starts the typical 9-month gestation period that is followed by childbirth. The fertilization of the ovum may be achieved by artificial insemination methods, which do not involve sexual intercourse. Assisted reproductive technology also exists.
Ovulation induction is the stimulation of ovulation by medication. It is usually used in the sense of stimulation of the development of ovarian follicles to reverse anovulation or oligoovulation.
Fertility clinics are medical clinics that assist couples, and sometimes individuals, who want to become parents but for medical reasons have been unable to achieve this goal via the natural course. Clinics apply a number of diagnosis tests and sometimes very advanced medical treatments to achieve conceptions and pregnancies.
In vitro maturation (IVM) is the technique of letting the contents of ovarian follicles and the oocytes inside mature in vitro. It can be offered to women with infertility problems, combined with In Vitro Fertilization (IVF), offering women pregnancy without ovarian stimulation.
Poor ovarian reserve is a condition of low fertility characterized by 1): low numbers of remaining oocytes in the ovaries or 2) possibly impaired preantral oocyte development or recruitment. Recent research suggests that premature ovarian aging and premature ovarian failure may represent a continuum of premature ovarian senescence. It is usually accompanied by high FSH levels.
Natural Cycle In Vitro Fertilization (IVF) is an assisted reproductive technique designed to closely mimic a woman's natural menstrual cycle. In traditional IVF, a woman's ovaries are stimulated with fertility medications to produce multiple eggs, which are then retrieved and fertilized outside the body. A natural cycle IVF, on the other hand, works with the woman's natural hormonal fluctuations and ovulation cycle.
Fertility testing is the process by which fertility is assessed, both generally and also to find the "fertile window" in the menstrual cycle. General health affects fertility, and STI testing is an important related field.
Infertility in polycystic ovary disease (PCOS) is a hormonal imbalance in women that is thought to be one of the leading causes of female infertility. Polycystic ovary syndrome causes more than 75% of cases of anovulatory infertility.
Partner-assisted reproduction, reception of oocytes from partner (ROPA), reciprocal IVF,shared motherhood, partner IVF or co-IVF is a method of family building that is used by couples who both possess female reproductive organs. The method uses in vitro fertilization (IVF), a method that means eggs are removed from the ovaries, fertilized in a laboratory, and then one or more of the resulting embryos are placed in the uterus to hopefully create a pregnancy. Reciprocal IVF differs from standard IVF in that two partners are involved: the eggs are taken from one partner, and the other partner carries the pregnancy. In this way, the process is mechanically identical to IVF with egg donation. Reciprocal IVF offers the highest chance for pregnancy and a lower risk of a multiple birth. Using this process ensures that each partner is a biological parent of the child. This fertility process is one way that allows lesbian and trans male couples to reproduce and both be involved in the physical process of becoming pregnant.
Luteal support is the administration of medication, generally progesterone, progestins, hCG or GnRH agonists, to increase the success rate of implantation and early embryogenesis, thereby complementing and/or supporting the function of the corpus luteum. It can be combined with for example in vitro fertilization and ovulation induction.
Antisperm antibodies (ASA) are antibodies produced against sperm antigens.
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