Besides a woman’s age, what are the top predictors of IVF success?
Ovarian reserve and body mass index (BMI) top the charts for IVF prediction. Both factors vary among women of all ages and together contribute approximately 20% to the overall picture of your chances of having a baby with IVF.
Your reserve may be discussed in the context of egg supply, which declines with age and can be measured indirectly through three clinical tests: 1) The level of the follicle stimulating hormone (FSH) on Day 3 of your menstrual cycle, 2) the number of “starter” antral follicles visible by ultrasound imaging of the ovaries at the beginning of your cycle, and 3) the level of the anti-mullerian hormone (AMH) in your blood.
Day 3 FSH
FSH is the primary follicle-stimulating hormone produced by the pituitary gland attached to your brain that drives the production of eggs in each menstrual cycle. In a healthy young woman, these levels are low on Day 3 and increase over the next week or two as follicles grow, producing progressively higher estrogen levels, which helps eggs to mature.
If your egg supply is low, your body still attempts to drive egg production by producing more FSH at an earlier time in the cycle. If FSH levels are higher than normal on Day 3 of the cycle, it is a good indication that ovarian reserve may be low.
In the first few days of your menstrual cycle, ultrasound imaging can detect a small group of “starter” or antral follicles visible on the ovaries. Those follicles are the pool of possible mature eggs for that cycle. A low antral follicle count at this point suggests that the total number of eggs in reserve is abnormally low.
AMH is produced by your ovarian follicles just before they are ready to start their final growing stage. AMH levels decline with age (Unlike Day 3 FSH, which rises as you get older). AMH blood tests can indicate the quantity of eggs remaining in the body, though they can’t be used to determine their quality, which also declines as ovaries age. Your AMH level does not change significantly from day-to-day of your cycle, so blood can be drawn at anytime. A low AMH level may mean that your ovarian reserve is also low.
Ovarian reserve is an important factor, but it alone cannot accurately determine your personal probability of getting pregnant with IVF. For example, your ovarian reserve may be above average for your age, but other fertility factors (body mass index, male factor, and others) could result in a lower probability of pregnancy. On the other hand, you may have a strong probability of success with IVF even if you have a low ovarian reserve due to good results in other fertility factors.
The Univfy PreIVFⓇ ReportTM is the only personalized report that uses all your health data and the outcome data of your IVF clinic to give you a more accurate prediction of success per cycle.
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Mylene Yao, MD, Co-Founder and CEO, has led Univfy since the e company started operations in 2010. Her vision is to make IVF more accessible to patients and to break barriers to treatment through the power of predictive analytics. Dr. Yao has over 15 years of experience in clinical and scientific research in fertility. Prior to founding Univfy, she was on the faculty at Stanford University, where she led NIH-funded fertility and embryo genetics research.
Dr. Yao graduated from medical school at the University of Toronto and completed her obstetrics and gynecology residency training at McGill University. She received her clinical subspecialty training in reproductive endocrinology and infertility at Brigham and Women’s Hospital at Harvard University. Dr. Yao received multiple research awards for her fertility research work, including pre-implantation embryo development, the role of stem cell genes in the embryo, and uterine receptivity at implantation, and is co-author of the chapter on Infertility in Novak’s Gynecology, one of the top medical textbooks for obstetricians and gynecologists.