Conception: assess your options and chances

Facts and figures

Becoming pregnant requires a complex combination of factors and events. For some couples, time, lifestyle changes or medical assistance may be necessary to achieve their dream. The good news is that most eventually do. These statistics may give you further insight.

For 80% of couples fertility problems can be traced back to a specific issue, leading to a course of appropriate action.¹ A complete diagnosis of both partners is essential to understanding the root of conception difficulties. Finding the cause of a problem is the first step to a solution.

• While many people associate infertility with women, it actually occurs both among women and men. Male infertility is the primary diagnosis in approximately 25% of cases and contributes to a further 15–25% of the remaining cases.¹ It is important that both partners are thoroughly investigated to determine the right course of action.
• Approximately 25% of women with fertility problems have problems with ovulation.¹ Clomiphene Citrate is a commonly prescribed drug used to stimulate ovulation in women who may not ovulate, or who only ovulate occasionally. Up to 45% of women responsive to this drug will conceive within six cycles.²

• If your initial course of treatment has not been successful, advanced treatment options may be recommended. Be reassured – the overall success rate of ART treatment is high. A Danish study from 2009 shows that within five years of starting ART treatment, almost 70% of couples succeed in having at least one child.³ At the same time, it’s important to remember that the success rate for fertility treatment is not absolute. The outcome will be different for every individual couple and clinic.

Assessing your clinic’s track record

It’s also important to understand how to interpret and compare success rates provided by your clinic:

• Success rates are linked to the patient profile and treatment approaches of a clinic. For example, some clinics may treat more or fewer complicated cases or older patients. Some may transfer more or fewer embryos within the limits of local regulations.
• Different definitions of pregnancy may be used.  A biochemical pregnancy is a pregnancy confirmed by blood or urine tests. When the pregnancy develops to the point that ultrasound technology confirms the existence of a gestational sac or that the uterus is growing bigger, it becomes a clinical pregnancy. Each of these stages may be a step towards a live birth, but doesn’t guarantee it. A biochemical pregnancy may result in a miscarriage before the 5th week of gestation – within a week of your missed menstrual period.
• Different denominators may be used for pregnancy rates. It‘s important to understand how pregnancy rates are calculated. If calculated per cycle started, the rate refers to the number of women who got pregnant out of all those who started treatment. Sometimes pregnancy rates are calculated counting only those women who achieved egg retrieval. Finally, pregnancy rates can be calculated from those who completed the process until embryo transfer. Important is that you and your partner take a closer look at how the rates are calculated to make sure you are looking at the same indicators when making comparisons and decisions. For example, the same clinic will have a lower pregnancy rate per treatment cycle started versus a pregnancy rate per embryo transfer. Remember, each of these steps is a step closer to a live pregnancy.

^{1. Collins J.A. Evidence-based infertility: evaluation of the female partner. International Congress Series 2004;1266: 57–62. 2. Medications for Inducing Ovulation. A Guide for Patients. ASRM 2006; 3. Pinbourg A et al, Prospective longitudinal cohort study on cumulative 5-year delivery and adoption rates among 1338 couples initiating infertility treatment. Hum Reprod.2009;24; 991-999.}