Cumulative live birth rates in in-vitro fertilization

Traditionally, in-vitro fertilization (IVF) success rates have been reported in terms of live birth per fresh cycle or embryo transfer. However, reporting IVF outcomes using cumulative live birth rates (LBR), defined as the first live birth following the use of all fresh and frozen embryos derived from a single ovarian stimulation cycle appears to be a better measure of IVF treatment success. Although there is an initial increase in fresh LBR with the number of oocytes retrieved, LBR either reach a plateau or may even decline when more than 15-20 oocytes are harvested. On the other hand, when all fresh and frozen embryos are taken into account, cumulative LBR have a significant positive association with ovarian response. Cumulative LBR are a more suitable are more comprehensive when reporting success in an IVF program. Cumulative LBR increase with the number of oocytes retrieved, suggesting that ovarian stimulation may have a minimal or no detrimental effect on oocyte/embryo quality.