This month, in Fertility & Sterility journal, an interesting study has been published. It was about the following question: who returns for another try after an IVF cycle? This study showed that younger women are more likely to return after a failed IVF cycle. It also showed that women with poor ovarian reserve were less likely to come back for another try. Another relevant finding is that people with a prior IVF birth had more chances of success in the second cycle.

These results are not surprising. People with higher chances of getting pregnant are more encouraged to keep trying than those with less chances. In other words, a 30 years-old woman that has a probability of success around 40% decides to keep trying because she feels that a probability of 4 in 10 is high, and success could happen on the next attempt. However, a 42 years-old woman with low AMH that has a probability of success below 5-10% (if using own eggs), could think that the number of attempts to get a pregnancy is high, in average; therefore,  some give up sooner.

When I read this paper, I started thinking about what we (doctors) should do to help our patients. When to encourage them to keep trying, when to encourage them to change the way of trying, when to stop with IVF treatments. Of course, there is no single answer. But I think that the key is to think over with the patients. First of all, the objective should be clear for everyone (doctor and patients): it is, usually, to have a baby at home. Secondly, all the alternatives (IUI, IVF, egg donation, etc) should be available on the table, to take the correct decision. Thirdly, success rates of each option should be clear for everyone. Fourth, little variations of each type of treatment should be offered, in order to provide new alternatives even when patients don’t want to make a big change in the treatment.\n\nIn summary, we (doctors) should help our patients to get to their objective as soon as possible, listening to their preferences, and applying our best knowledge. Share information is always the clue. Even for this, to avoid that some patients give up and resign the opportunity to have a baby.