What Do Women Undergoing IVF Understand About Their Chance of Success?
Introduction
In vitro fertilization (IVF) is one of the most widely used assisted reproductive technologies and provides an important treatment option for people experiencing infertility. However, IVF does not have the same likelihood of success for every woman. The probability of achieving a pregnancy or having a baby depends on several individual factors, including age, infertility history, the underlying cause of infertility, and previous treatment outcomes.
Understanding the likelihood of success is an important part of informed decision-making before and during fertility treatment. Patients need to understand that IVF does not guarantee pregnancy or live birth and that an individual's chance of success may differ substantially from general success rates reported by clinics or public sources.
A study by McMahon and colleagues, published in Human Reproduction in 2024, examined how well Australian women undergoing IVF understood their personal chance of having a baby.
Study Objective
The primary aim of the study was to determine how accurately women undergoing IVF could estimate their individual chance of having a baby following an IVF treatment cycle.
The researchers also investigated where women preferred to obtain information about IVF success, how well they felt their doctors explained their chances of success, and what additional information they wished they had received when they started treatment.
Study Design and Methods
The researchers conducted an anonymous online survey involving 217 women in Australia who had started IVF treatment since 2018.
Participants completed questions about their demographic characteristics, IVF history, and understanding of IVF success. They were asked to estimate their own chance of having a baby following one IVF treatment cycle.
Their estimates were then compared with an estimated individual probability calculated using the Society for Assisted Reproductive Technology (SART) online calculator.
Participants were also asked to rate their own knowledge about IVF success probabilities and to describe their experiences of receiving information from doctors and fertility clinics.
A free-text question asked women what information they wished they had been given when they started treatment. These responses were subsequently analysed thematically.
Key Findings
The study found that only approximately one in four women (27%) accurately estimated their individual chance of having a baby.
Of the 217 participants, 58 women provided an estimate that was within 20% of their calculated probability.
In contrast, 118 women (54%) overestimated their chance of success.
These results suggest that being familiar with IVF success rates does not necessarily mean that patients understand their own individual probability of success.
This distinction is important because expectations about IVF can influence many treatment decisions, including how many treatment cycles a patient may consider, financial planning, emotional preparation, and consideration of alternative fertility options.
The Role of Doctors in Providing Information
The study also highlighted the importance of communication between fertility specialists and patients.
Approximately 90% of women reported that a consultation with their doctor was their preferred source of information about fertility treatment.
However, fewer than half of the participants—approximately 44%—felt that their doctors had explained the probability of having a baby with IVF well.
The average rating for how well doctors explained the chance of success was 5.9 out of 10.
These findings suggest that there may be opportunities to improve the way IVF success probabilities are communicated during fertility consultations.
What Information Did Women Want?
Many women who responded to the free-text question reported that they would have liked to receive more realistic and clearer information about IVF and their personal chance of success before beginning treatment.
One important issue is that IVF success rates are not a single number that applies equally to every patient. Individual chances can vary considerably depending on personal and treatment-related characteristics.
Clear explanations of the factors that influence success may therefore help patients develop more realistic expectations and make better-informed decisions.
Why Does Understanding IVF Success Matter?
IVF can involve substantial physical, emotional, financial, and time-related commitments. For this reason, understanding the probability of success is an important part of fertility treatment planning.
If patients substantially overestimate their likelihood of success, they may enter treatment with expectations that are higher than the statistical probability. Conversely, accurate information can help patients consider the potential benefits, limitations, costs, and alternatives associated with treatment.
It is important to recognize, however, that even the most accurate statistical estimate cannot predict the outcome for an individual patient with certainty. A calculated probability represents a statistical estimate, not a guarantee of pregnancy or live birth.
Limitations of the Study
The study had several limitations.
Participants were recruited through social media, meaning that a response rate could not be calculated. It is also uncertain whether the participants were representative of all women undergoing IVF in Australia.
Women who decided not to undergo IVF were not included. Consequently, women with particular expectations about IVF success may have been more likely to participate in the survey.
There is also some inherent imprecision in comparing women's personal estimates with calculated probabilities. Recall bias may also have influenced some responses.
Finally, the study cannot determine precisely whether inaccurate estimates were primarily caused by insufficient information from clinicians and fertility clinics or by optimism bias among patients.
Conclusion
The findings of McMahon and colleagues indicate that a substantial proportion of women undergoing IVF do not accurately understand their individual probability of success, with more than half of the participants overestimating their chance.
At the same time, most women reported that they would prefer to receive information about IVF success from their doctors, while fewer than half felt that their chances had been adequately explained.
These findings highlight the importance of clear, realistic, and individualized counselling before and during IVF treatment.
Providing understandable information about the probability of success should not be intended to create either unrealistic optimism or unnecessary pessimism. Rather, accurate communication can help patients understand their options, establish realistic expectations, and participate more actively in decisions about their fertility treatment.
Ultimately, IVF success rates should be presented as individualized statistical estimates rather than guarantees, allowing patients and their fertility specialists to make treatment decisions based on the patient's specific circumstances.
Reference: McMahon C, et al. What do women undergoing in vitro fertilization (IVF) understand about their chance of IVF success? Human Reproduction. 2024.