A simple online calculator uses a woman’s individualized metrics to calculate the odds of success for in vitro fertilization.
Launched in early February, the Assisted Reproductive Technology Patient Predictor Tool allows a woman to estimate her chances of success based on her own physiologic characteristics: body mass index, age, pregnancy history, and infertility diagnosis.
The tool, created by the Society for Assisted Reproductive Technology (SART), draws on data compiled since 1992, comprising more than 1 million IVF treatment cycles among more than 300,000 women, according to Dr. Jim Toner, SART president.
Dr. Jim Toner
“We’ve been trying [as an organization] to come up with a good prediction tool for a number of years,” Dr. Toner said in an interview.
Typically, patients turn to preset tables to get some idea of how well they might do with IVF. But those tables include just a few variables and can’t provide individualized assessments, he said.
“This is much more user friendly than the typical clinical tables. I do think this is now the best tool out there for a patient to get a handle on what her chances for success might be,” Dr. Toner said. ”And I think this is likely to become a top search result for infertile couples who are seeking treatment. It will get heavy use by couples trying to understand their choices.”
The online tool is simple: It asks for age, height, weight, and the number of prior pregnancies and full-term births; and lets users choose from a list of possible infertility diagnoses. Patients then indicate whether they will use their own eggs or donor eggs. The tool calculates the probability of a live birth after one, two, and three IVF cycles. It also calculates the chance of single or multiple births, taking into account the number of embryos transferred.
Dr. Toner said he sees great potential in the tool’s ability to provide a framework for an initial discussion with a reproductive specialist. Sometimes, he said, couples are so eager to conceive that physicians need to impose some realism on the conversation.
“Couples are normally quite motivated to do whatever it takes, and sometimes it’s almost hard to talk them out of it, even with very low prospects,” he said. “They can look at a 15% live delivery rate from a clinic and say, ‘Wow, that’s not too bad!’ ”
Getting an individualized assessment from the risk calculator puts everyone on the same footing when discussions start, Dr. Toner said.
The calculator’s ability to predict the likelihood of multiples is another benefit, he said. While the medical literature is clear on the problems inherent in multiple births, and most clinics are doing everything they can to minimize those pregnancies, it can still be a hard sell to prospective parents, he said.
“Most people think that twins are good – two for the price of one. But they actually do have a lot more problems than people are aware of ... more cerebral palsy, more learning disabilities, more attention-deficit/hyperactivity disorder,” Dr. Toner said. “The discussion of multiples is one that needs to occur and it needs to occur early.”
The calculator employs more than two decades of U.S. data on assisted reproduction. In 1992, the Fertility Clinical Success Rate and Certification Act was passed, mandating that all ART clinics report success rate data to the federal government in a standardized manner. The Centers for Disease Control and Prevention began collecting the information in 1996, via the web-based National ART Surveillance System (NASS). SART also collects its own data from clinics, Dr. Toner said.
This is just the IVF calculator’s first iteration; SART officials are working on adding other features.
“One weakness in this first model, especially for the younger population, is that it doesn’t factor the potential for pregnancies from frozen embryos,” Dr. Toner said. “If you get four good embryos and freeze three, this calculator doesn’t take the potential of those three into account, only the potential of the one that is put back.”
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