Pregnancy Rate
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Pregnancy rate is the success rate for getting
pregnant Pregnancy is the time during which one or more offspring gestation, gestates inside a woman's uterus. A multiple birth, multiple pregnancy involves more than one offspring, such as with twins. Conception (biology), Conception usually occurs ...
. It is the percentage of all attempts that leads to pregnancy, with attempts generally referring to menstrual cycles where
insemination Insemination is the introduction of sperm (in semen) into a female or hermaphrodite's reproductive system in order to fertilize the ovum through sexual reproduction. The sperm enters into the uterus of a mammal or the oviduct of an oviparous (eg ...
or any artificial equivalent is used, which may be simple
artificial insemination Artificial insemination is the deliberate introduction of sperm into a female's cervix or uterine cavity for the purpose of achieving a pregnancy through in vivo fertilization by means other than sexual intercourse. It is a fertility treatment ...
(AI) or AI with additional
in vitro fertilization In vitro fertilisation (IVF) is a process of fertilisation in which an egg is combined with sperm in vitro ("in glass"). The process involves monitoring and stimulating the ovulatory process, then removing an ovum or ova (egg or eggs) from ...
(IVF).


Definitions

There is no universally accepted definition of the term. Thus in IVF pregnancy rates may be based on initiated treatment cycles, cycles that underwent oocyte retrieval, or cycles where an
embryo transfer Embryo transfer refers to a step in the process of assisted reproduction in which embryos are placed into the uterus of a female with the intent to establish a pregnancy. This technique - which is often used in connection with in vitro fertili ...
was performed. In terms of outcome, "pregnancy" may refer to a positive
pregnancy test A pregnancy test is used to determine whether a person is Pregnancy, pregnant or not. The two primary methods are testing for the pregnancy hormone (human chorionic gonadotropin (hCG)) in blood or urine using a pregnancy test kit, and scanning ...
, evidence of a pregnancy with a "viable" fetus or implantation. Furthermore, pregnancy rates can be influenced in IVF by transferring multiple embryos that may result in
multiple birth A multiple birth is the culmination of a multiple pregnancy, wherein the mother gives birth to two or more babies. A term most applicable to vertebrate species, multiple births occur in most kinds of mammals, with varying frequencies. Such births ...
s. A strict definition in the IVF setting would refer to the singleton pregnancy rate that determines how many live singletons are born in relation to initiated IVF cycles.


Related end-points

In some cases, success rates include delivery or presence of a live baby (preferably specified as ''delivery rate'' or ''live
birth rate Birth rate, also known as natality, is the total number of live childbirth, human births per 1,000 population for a given period divided by the length of the period in years. The number of live births is normally taken from a universal registr ...
'' respectively).


Fertilization rate

In IVF or its derivatives, ''fertilization rate'' may be used to measure how many oocytes become fertilized by sperm cells. A fertilization rate of zero in one cycle, where no oocytes become fertilized, is termed a ''total fertilization failure''. Repeated ICSI treatment may be useful or necessary in couples with total fertilization failure.


Implantation rate

Implantation rate is the percentage of embryos which successfully undergo implantation compared to the number of embryos transferred in a given period. In practice, it is generally calculated as the number of intrauterine
gestational sac The gestational sac is the large cavity of fluid surrounding the embryo. During early embryogenesis, it consists of the extraembryonic coelom, also called the chorionic cavity. The gestational sac is normally contained within the uterus. It is the ...
s observed by transvaginal ultrasonography divided by the number of transferred embryos. As an example, one center in the United States reported an implantation rate in IVF of 37% at a maternal age of less than 35 years, 30% at 35 to 37 years, 22% at 38 to 40 years, and 12% at 41 to 42 years. Successful implantation of the
zygote A zygote (; , ) is a eukaryote, eukaryotic cell (biology), cell formed by a fertilization event between two gametes. The zygote's genome is a combination of the DNA in each gamete, and contains all of the genetic information of a new individ ...
into the
uterus The uterus (from Latin ''uterus'', : uteri or uteruses) or womb () is the hollow organ, organ in the reproductive system of most female mammals, including humans, that accommodates the embryonic development, embryonic and prenatal development, f ...
is most likely 8 to 10 days after conception. If the zygote has not implanted by day 10, implantation becomes increasingly unlikely in subsequent days.


Live birth rate

Live birth rate is the percentage of all cycles that lead to live birth, and is the pregnancy rate adjusted for
miscarriage Miscarriage, also known in medical terms as a spontaneous abortion, is an end to pregnancy resulting in the loss and expulsion of an embryo or fetus from the womb before it can fetal viability, survive independently. Miscarriage before 6 weeks ...
s and
stillbirth Stillbirth is typically defined as fetus, fetal death at or after 20 or 28 weeks of pregnancy, depending on the source. It results in a baby born without vital signs, signs of life. A stillbirth can often result in the feeling of guilt (emotio ...
s. For instance, in 2007, Canadian clinics reported a live birth rate of 27% with
in vitro fertilisation In vitro fertilisation (IVF) is a process of fertilisation in which an ovum, egg is combined with spermatozoon, sperm in vitro ("in glass"). The process involves monitoring and stimulating the Ovulation cycle, ovulatory process, then removing ...
.


General factors

There is a substantial connection between
age and female fertility Female fertility is affected by ageing, age and is a major fertility factor (demography), fertility factor for women. A woman's fertility is in generally good quality from the late teens to early thirties, although it declines gradually over time. ...
.
Menarche Menarche ( ; ) is the first menstrual cycle, or first menstruation, menstrual bleeding, in female humans. From both social and medical perspectives, it is often considered the central event of female puberty, as it signals the possibility of fe ...
, the first menstrual period, usually occurs around 12–13, although it may happen earlier or later, depending on each girl. After
puberty Puberty is the process of physical changes through which a child's body matures into an adult body capable of sexual reproduction. It is initiated by hormonal signals from the brain to the gonads: the ovaries in a female, the testicles i ...
, female fertility increases and then decreases, with
advanced maternal age Advanced maternal age, in a broad sense, is the instance of a woman being of an older age at a stage of reproduction, although there are various definitions of specific age and stage of reproduction. The variability in definitions is in part e ...
causing an increased risk of
female infertility Female infertility refers to infertility in women, which is the inability to Fertilisation, conceive after sexual intercourse. It affects an estimated 48 million women, globally. Female infertility varies widely by region. The highest rates of ...
. A 2001 review suggested a
paternal age effect The paternal age effect is the statistical relationship between the father's age at conception and biological effects on the child. Such effects can relate to birthweight, congenital disorders, life expectancy, and psychological outcomes. A 20 ...
on fertility, where older men have decreased pregnancy rates.


Pregnancy rate for sexual intercourse

The time with the highest likelihood of pregnancy resulting from
sexual intercourse Sexual intercourse (also coitus or copulation) is a sexual activity typically involving the insertion of the Erection, erect male Human penis, penis inside the female vagina and followed by Pelvic thrust, thrusting motions for sexual pleasure ...
covers the
menstrual cycle The menstrual cycle is a series of natural changes in hormone production and the structures of the uterus and ovaries of the female reproductive system that makes pregnancy possible. The ovarian cycle controls the production and release of eg ...
time from some 5 days before until 1 to 2 days after ovulation. In a 28‑day cycle with a 14‑day luteal phase, this corresponds to the second and the beginning of the third week. A variety of methods have been developed to help individual women estimate the relatively fertile and the relatively infertile days in the cycle; these systems are called
fertility awareness Fertility awareness (FA) refers to a set of practices used to determine the fertile and infertile phases of a woman's menstrual cycle. Fertility awareness methods may be used to avoid pregnancy, to achieve pregnancy, or as a way to monitor gyne ...
. There are many fertility testing methods, including
urine test A urine test is any medical test performed on a urine specimen. The analysis of urine is a valuable diagnostic tool because its composition reflects the functioning of many body systems, particularly the kidneys and urinary system, and specimens ...
kits that detect the
LH surge Luteinizing hormone (LH, also known as luteinising hormone, lutropin and sometimes lutrophin) is a hormone produced by gonadotropic cells in the anterior pituitary gland. The production of LH is regulated by gonadotropin-releasing hormone (GnR ...
that occurs 24 to 36 hours before ovulation; these are known as ovulation predictor kits (OPKs). Computerized devices that interpret basal body temperatures, urinary test results, or changes in saliva are called fertility monitors. Fertility awareness methods that rely on cycle length records alone are called
calendar-based methods Calendar-based methods are various methods of estimating a woman's likelihood of fertility, based on a record of the length of previous menstrual cycles. Various methods are known as the Knaus–Ogino method and the rhythm method. The standard days ...
. Methods that require observation of one or more of the three primary fertility signs (
basal body temperature Basal body temperature (BBT or BTP) is the lowest body temperature attained during rest (usually during sleep). It is usually estimated by a temperature measurement immediately after awakening and before any physical activity has been undertaken. ...
,
cervical mucus The cervix (: cervices) or cervix uteri is a dynamic fibromuscular sexual organ of the female reproductive system that connects the vagina with the uterine cavity. The human female cervix has been documented anatomically since at least the tim ...
, and cervical position) are known as symptoms-based methods. For optimal pregnancy chance, there are recommendations of sexual intercourse every 1 or 2 days, or every 2 or 3 days. Published date: February 2013. Last updated: September 2017 Studies have shown no significant difference between different sex positions and pregnancy rate, as long as it results in
ejaculation Ejaculation is the discharge of semen (the ''ejaculate''; normally containing sperm) from the penis through the urethra. It is the final stage and natural objective of male sexual stimulation, and an essential component of natural conception. ...
into the
vagina In mammals and other animals, the vagina (: vaginas or vaginae) is the elastic, muscular sex organ, reproductive organ of the female genital tract. In humans, it extends from the vulval vestibule to the cervix (neck of the uterus). The #Vag ...
. According to the ''American Pregnancy Association'', the following factors of sexual intercourse may increase pregnancy chances: *The woman raising her
hips In vertebrate anatomy, the hip, or coxaLatin ''coxa'' was used by Celsus in the sense "hip", but by Pliny the Elder in the sense "hip bone" (Diab, p 77) (: ''coxae'') in medical terminology, refers to either an anatomical region or a joint ...
about 3 to 4 inches in order to allow gravity to assist with drawing the sperm towards the cervix opening and into the uterus, but there is no scientific data that confirms any beneficial effect of this practice. *Having sexual intercourse in the morning, by providing the best
sperm quality Semen quality is a measure of male fertility Fertility in colloquial terms refers the ability to have offspring. In demographic contexts, fertility refers to the actual production of offspring, rather than the physical capability to reproduce, ...
. *Avoiding hot tubs before sex because the high temperature is harmful to sperm. *Avoiding vaginal douching before or after sex because the altered vaginal acidity is harmful to sperm, and washes away the fertility-beneficial
cervical mucus The cervix (: cervices) or cervix uteri is a dynamic fibromuscular sexual organ of the female reproductive system that connects the vagina with the uterine cavity. The human female cervix has been documented anatomically since at least the tim ...
. *Avoiding
lubricant A lubricant (sometimes shortened to lube) is a substance that helps to reduce friction between surfaces in mutual contact, which ultimately reduces the heat generated when the surfaces move. It may also have the function of transmitting forces, ...
s unless they are sperm-friendly.


Pregnancy rate for artificial insemination

Generally, the pregnancy rate for artificial insemination is 10–15% per
menstrual cycle The menstrual cycle is a series of natural changes in hormone production and the structures of the uterus and ovaries of the female reproductive system that makes pregnancy possible. The ovarian cycle controls the production and release of eg ...
using ICI,Utrecht CS News
Subject: Infertility FAQ (part 4/4)
and 15–20% per cycle for IUI.


Pregnancy rate for ''in vitro'' fertilization

With enhanced technology, the pregnancy rates are substantially higher today than a couple of years ago. In 2006, Canadian clinics reported an average pregnancy rate of 35%.Success rate climbs for in vitro fertilization
The Canadian Press. December 15, 2008 at 8:27 PM EST


References

{{reflist Human pregnancy Rates