Rose had two heartbreaking losses. Then her specialist clocked one crucial detail

One child in 16 is now conceived via IVF in Australia as success rates creep up, but would-be parents face a high-stakes numbers game in which age, and the clinic they choose, can determine success – or otherwise.

More than 50,000 women in Australia had IVF treatment in 2024, totalling 104,721 IVF cycles, according to the latest analysis of the database tracking every cycle performed at every IVF clinic in Australia and New Zealand.

There were 18,509 IVF babies born in 2024, equating to one baby for every five to six cycles, says the report published on Sunday by UNSW’s National Perinatal Epidemiology and Statistics Unit (NPESU).

Success rates varied widely between IVF clinics. One clinic – its identity was not revealed– reported just over 5 per cent of its initiated cycles resulted in a live birth. At the other end of the scale was a clinic with a 38 per cent success rate.

Male infertility was a factor for one in four IVF cycles. The specific cause in the majority of these cases was unknown.

Of all the causes of infertility among people undergoing IVF, women diagnosed only with endometriosis had the highest chance of success. More than one in three (36.3 per cent) of initiated cycles resulted in a live birth.

Rose Larkins was 27 when she and her husband, Brendon, started trying for a baby. After a procession of increasingly intensive fertility treatments, she started IVF at 33. Her only egg retrieval resulted in four embryos.

It was heartbreaking when her first two embryo transfers failed. “IVF was extremely overwhelming,” Larkins said.

She recalled her first IVF specialist’s pro-forma PowerPoint presentation. “Then he put me on an IVF treatment plan he said he starts all his patients on … there was no consideration of my medical history,” Larkins said.

Her second fertility specialist spent the first appointment taking a detailed history and put her on a fraction of the medication dosage previously prescribed, which she lowered after Larkins almost developed ovarian hyperstimulation syndrome.

The couple had addressed Brendon’s treatable condition causing male infertility, and Rose’s benign tumour of the pituitary gland. But the specialist picked up on a crucial component that Rose had raised years earlier with other doctors.

“I had always had painful periods to the point where [at work] I was crawling under my desk and half passing out,” Larkins said. “She asked me, ‘Have you ever had a laparoscopy?’”

The procedure revealed Larkins had severe, widespread and deep infiltrating endometriosis. Three months after surgery to remove endometrial lesions, her specialist transferred the embryo that would become her son, Theodore, now 3.

Her 14-month-old daughter, Maia, was conceived with her last embryo.

“I have two beautiful little miracles that I wouldn’t otherwise have,” she said, but the all-consuming experience took a toll. She has joined the NPESU’s consumer advisory group in the hopes of improving the sector.

IVF clinic medical directors said aggregated success rates are misleading because they penalised clinics that treated the most complex or older patients.

Professor Georgina Chambers, the director of NPESU and the report’s lead author, agreed but said there may be unwarranted variation between clinics. She hoped an independent regulator for the IVF sector would make publishing success rates mandatory for all IVF clinics.

Overall, 37 per cent of women had a live birth from their first complete cycle. By the sixth complete cycle, that rose to 57.6 per cent, but age was a powerful predictor.

The chance of having a baby per frozen embryo cycle when women used their own eggs was 38.4 per cent among those aged 30 to 34. This dropped to 12.2 per cent for women 45 and older, many of whom would have frozen their eggs when they were younger.

For fresh embryo transfers, the chance of having a baby per initiated cycle dropped from 28.7 per cent in the 30-34 cohort to 1.4 per cent in those over 45.

“If a woman isn’t successful in her first cycle, the report provides reassuring data that after multiple cycles, she had a very good chance of having a baby,” Chambers said.

After three complete IVF cycles and using their own eggs, women starting IVF under 30 have a 70 per cent chance of having a baby, falling to 21 per cent for women between 40 and 44, and 3 per cent after 45.

“But every woman is different,” Chambers said, urging anyone considering IVF to use the calculator on Your IVF Success for an individualised estimate.

Michael Chapman, co-founder of IVF Australia and Professor of Obstetrics and Gynaecology at UNSW, said Australia was leading the world in terms of transferring just one embryo at a time.

“When I started in the ’80s, we would put back two, three or four embryos at once, got a 10 per cent pregnancy rate and thought we were doing pretty well,” Chapman said.

Dr Petra Wale, president of the Fertility Society of Australia and New Zealand, which funded the report, said single embryo transfers and freezing embryos allowed clinics to reduce the risks of multiple pregnancies and gave patients the best possible chance of building a healthy family.

Frozen embryos accounted for roughly 70 per cent of embryos transferred in 2024. Freezing embryos allows women to recover from ovarian stimulation before a transfer, and in some cases for those embryos to undergo preimplantation genetic testing.

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