When we talk about how you can increase your IVF success rate a lot of people believe that the success rate is not high, and this is not true. IVF is without a doubt the most effective treatment for infertility. Especially in Nigeria, where the male factor (sperm count, sperm parameters) and tubal factors are the commonest reasons for infertility. These two things can only be well taken care of with IVF and its variants. Now, the success rate of IVF is getting better compared to what we had 10 – 20 years ago. To have better knowledge about IVF, you need to understand what we mean by IVF success rate. When asked the question, what do you think the success rate of IVF is? Some people say 60%, some say 80%. Some physicians are also not helping issues by not giving their patient the correct data about what to expect when they are doing IVF.  

We can look at the success rate of IVF from two perspectives: 

• The clinical pregnancy rate – Patients often feel that once they get a positive pregnancy test after their IVf cycle, it is a success.  But that is not correct, even looking at clinical pregnancy rate we only say a cycle is successful when we are able to demonstrate or scan that the live baby is in the uterus. That is what we refer to as clinical pregnancy rate. 
• Natural conception – What many patients want to look at is the live birth rate or what some call the take home baby rate. If 100 people do IVF, how many will take babies home? And generally, about 40% of women who are less than 35 years old will be able to take babies home after doing IVF. But that is not the majority, only about 20 – 25% of women will be able to take babies home. That is the figure the national infertility association presented. Every month, nature can only offer 15 – 20%. So if we say up to about 40% or even 20-35% can take babies home, the IVF is actually more efficient than nature itself. It is also important to note that the majority of the people doing IVF have infertility problems.

In the United Kingdom, the national average of people who use their own eggs is 27%, that is the figure HFU presented in 2018. The fact that you are doing IVF gives no  guarantee that the first cycle will work. That is why it is recommended that a woman under 35 years should prepare for two cycles. If she is over 35, she should prepare for three cycles. If the first cycle works, fine. This success rate decreases when she is over 35 and is using her own eggs. In other words you might need more than one cycle of treatment for you to achieve your dreams.  People often ask these questions, “everything went well during my IVF cycle, my embryo was good, my uterus was okay, why am I not pregnant?” This is a very serious question but to answer these questions we need to go to the basics. 

Basic requirement for a successful IVF cycle
To have a successful cycle, a couple must have:

• Good quality eggs. 
• Good quality sperm.

Most of the time, these two might not be present but when they come together in fertilization, we should be able to have genetically normal embryos. The embryos should be of good quality and also genetically normal.  Also, you also need a good check.  This is where the doctor comes in, he/she must do a smooth transfer. The embryo that has been transferred will need to implant into the uterus. All these things must happen to have a successful pregnancy. When people ask for the reason why their IVF cycle failed, what they don’t understand is that each couple carries their success rate. When the laboratory is working well and the doctors are experienced. 

Factors that can affect IVF success rate

• Age: There is no limit in age for anyone doing IVF, but that depends on where the egg is coming from. When a woman is using her own eggs over and over again the success rate decreases. When you are 35 and above, you need to prepare for this. Unfortunately, age is one thing that nothing can be done to fix. This is why women are advised to freeze their eggs when they are young.  If you are 42, there is nothing you can do to bring down your age. Some people even ask if drugs can make the quality of the eggs better? There are still no drugs that can do that yet. Most of the things we talk about are in the genes, some changes will have taken place in the genes because of age and there is no way you can reverse that. You can take multivitamins or any drugs but there is nothing right now to improve the quality of eggs. 

One thing people overlook is the age of the man. They pay so much attention to the age of the woman and the man also matters. In fertilization, what happens is the exchange of genetic materials. In men who are older than 45, we see a fall in their genetic materials because of exposure to the environment. There is fragmentation of genetic material and the fertilization rate is low but this does not mean that they can’t have babies.

• Medical history: If you have any underlying health issues, it is important that you let your doctor know about it. When you share the complete story, your doctor will know all the tests to do. We know that diabetics can affect the rate of implantation especially when it is uncontrolled. We did a review of 3000 women in our clinic and looking at the group age of patients in Nigeria, our unique age was 37. Nigerian women mostly visit the fertility clinic after they are 35 and that affects success rate. 
• Race: Success rate for IVF is poorer in black women than caucasians, but that is still a source of controversy. People say some of the things that are present in our body might be the cause. For example Fibroids. Black women have more fibroids and that might be responsible for the less success rate we have. The study we did on over 3000 women, the BMI of patients was about 28. Our women tend to be on the fatter side. If you need IVF, do not procrastinate. Do the IVF on time, because age is a critical success factor in IVF. If I may say, it is probably the only thing that is actually irreversible. 
• Pregnancy history: People who have had previous successful pregnancies tend to have successful cycles better than people who have never been pregnant. If your history shows that you have had recurrent miscarriages, it is important to share this information. Your doctor might need to do additional investigation and treatments for you. Pregnancy history is very important to share when you are talking to your doctors. Reproductive medicine is a little bit different from the other part of medicine where sometimes it is the doctor who makes all the decisions. You go to a doctor, you complain and he gives you a prescription. It is not like that in reproductive medicine, we need to discuss and therefore you need to be comfortable with the people looking after you when you have infertility. 
• Type of infertility: Tubal infertility especially when there is blockage of tubes with collection of water in the tubes, what we call hydrosalpinx affects success rate of IVF. That might need to be attended to before you do your IVF. Hydrosalpinx reduces the success rate of IVF because the infected fluids in the tubes can go back to the uterus and infect the endometrium and therefore reduce the chance of getting pregnant. It is important that the doctor should be able to do laparoscopy to be able to clean the tube. 
• Uterine fibroid but especially submucous fibroid: This affects the implantation rate in IVF. There must be an avenue for the clinic to take care of your fibroid, if it is going to affect your success rate. It is not every fibroid that affects success rate, the one that affects success rate is the one that sits where the baby should sit. This will disturb the implantation.
• Ovarian disorder: This is when the ovaries are not functioning properly. There are some women who are 30 years old but their ovaries are like that of a 40-year-old woman. In such people, it is advised that they do multiple cycles. To do multiple cycles, your clinic must have the capacity to freeze either eggs or embryos.  Some people have multiple factors for infertility. For example, the egg quality is probably because of age and their sperm quality is also bad, they might not achieve their dreams in one cycle. At least one of the materials has to be good for us to get a decent result. IVF is not just something you embark on doing, we have to look at the factors of all the things we are working with. This is why a very good discussion with the doctor is very important. 
• Length of infertility: This also has a direct effect on IVF success rate. Sometimes it is important to decide on the source of your eggs. Should you use your eggs or donor eggs? One of the things infertility does to you is to make you feel like the world is falling on you. But it is not. So many people are also going through it.

Lifestyle Choices That Can Affect IVF Success Rate

• Smoking: This affects the quality of the sperm and the eggs. The outcome of IVF is worse in smokers, they might require twice the number of IVF cycles a non-smoker needs. If you are smoking whether you are a man or woman if you want to do IVF , it is either you stop or drastically reduce it. You can’t continue to smoke and you expect IVF to work.
  
• Obesity: This also affects the success rate of IVF
• Coffee Intake: If you are a heavy coffee drinker, you need to reduce your intake if you want to achieve success in your IVF cycle. 

These are some things to consider before you do the treatment if you want to get a positive result. IVF is not magic, it is science and there are rules to it. There are conditions that must be met for you to get anything out of it. IVF is not only about the patients, the clinic where you are doing your treatment also matters. The quality of their laboratory is important. The qualification and experience of the staff looking after you is important. When they say practice makes perfect, it is so true in IVf. The number of cycles that you have done also gives you the kind of experience you need. You have to look at the facilities your IVF clinic has. 

It is important that you do your research properly before you choose your fertility clinic. You need to prepare both physically and physiologically. The treatment of infertility is not a picnic, you need to be prepared and must be free to talk openly with your caregivers.  You must be able to talk to them and they must be people who can explain what to do to you. You need to understand the procedure you are going into and you must ask questions. You must take time to talk to a counsellor or a support group.

Also, you need to prepare to take more than one cycle, so if the clinic is offering you more than one cycle take it.  It is important you go to the clinic, talk to them to ascertain that they are credible people. You should consider adding acupuncture  to your treatment. It helps you to relax. Also keep your ideal body weight. If you have to lose weight before your treatment.