Many couples struggling with infertility turn to in vitro fertilization (IVF) to help them conceive. IVF involves combining eggs and sperm in a lab to create embryos that can then be transferred into the uterus. However, IVF is expensive, invasive, and does not always result in a successful pregnancy on the first try. This leads some couples to try getting pregnant naturally again after completing one or more rounds of IVF. But is it actually harder to conceive naturally after doing IVF? There are a few factors to consider.
Possible Explanations for Decreased Fertility After IVF
There are several possible reasons why fertility may decrease after IVF, including:
Older Maternal Age
By the time most couples try IVF, they have often been attempting to conceive naturally for months or years. This means the female partner is older when they complete IVF cycles. Advanced maternal age lowers the chances of conception both naturally and with fertility treatments.
Fewer Viable Eggs
The process of stimulation and egg retrieval can reduce the ovarian reserve. So after IVF, there may be fewer viable eggs remaining in the ovaries. Having a low egg count makes it harder to get pregnant naturally.
Increased Pregnancy Complications
Any pregnancies achieved after IVF have higher risks of problems like miscarriage, ectopic pregnancy, and preterm delivery. These complications can make successfully carrying a pregnancy to term less likely.
Uterine or Tubal Issues
Some underlying uterine or fallopian tube problems lead couples to need IVF in the first place. These issues typically do not resolve on their own and can still interfere with conception after IVF.
Male Factor Infertility
Male factor infertility including low sperm count or motility does not improve spontaneously after IVF. The same sperm-related problems will still hinder natural conception post-IVF.
Accumulated Physical and Emotional Stress
The IVF process brings physical stresses from hormone shots and egg retrieval procedures. Couples also experience great emotional ups and downs from the cycle of hope and disappointment when treatment fails. This stress can take a toll and make it harder to conceive going forward.
Studies Investigating Fertility After IVF
So theoretically, natural conception could become more difficult after IVF. But what does the evidence actually show? There have been several studies investigating fertility rates in couples trying to conceive naturally after undergoing IVF treatment cycles.
Fertility After 1 IVF cycle
In 2016, researchers publishing in the journal Human Reproduction followed 158 women trying to conceive naturally for 6 months after their first IVF cycle. Of those women:
- 27% conceived naturally within 6 months after IVF
- 9% more conceived within 12 months after the end of the study
The pregnancy rate was lower than the average monthly fecundity rate of 20%–25% expected in fertile couples trying to conceive naturally. But over one-third did conceive within a year of completing their first IVF cycle.
Fertility After Multiple IVF Cycles
Other studies have looked specifically at conception rates after multiple failed IVF cycles. One study followed 225 couples with unexplained infertility who completed 2-6 IVF cycles without success. In the 18 months after discontinuing treatment:
- 29% conceived naturally
- 71% did not conceive
Among women over age 35, only 8% conceived naturally compared to 37% under 35. The researchers concluded age was the main factor influencing fertility after multiple failed IVF cycles.
Secondary Infertility After IVF
Another question researchers have examined is whether IVF increases the risk for secondary infertility. Secondary infertility refers to the inability to conceive a second pregnancy after previously having one or more children.
One study looked at birth rates in over 40,000 women with secondary infertility. Around 30% had previously undergone fertility treatments. The birth rates were:
- IVF group – 52% gave birth again
- No treatment group – 67% gave birth again
The secondary infertility was not necessarily caused by the IVF. But the findings do show lower subsequent birth rates for women who needed IVF for their first pregnancy.
Factors That Improve Fertility After IVF
Despite some studies showing decreased fertility rates after IVF, there are still several factors that can optimize the chances of natural conception post-IVF.
Short IVF Treatment Duration
The likelihood of successful natural conception declines with increased duration of IVF treatment. Couples who do 1-3 IVF cycles then take a break have better outcomes than those who do many back-to-back cycles.
No Male Factor Infertility
If infertility is due to female factors only, fertility potential remains higher after IVF. Sperm quality and count do not change spontaneously.
Previous Successful Pregnancies
Women who deliver a baby from IVF treatment have higher natural conception rates afterward than those whose IVF cycles did not result in a live birth.
Younger Age
The younger the female partner is when undergoing IVF, the better the chances of conceiving naturally later. Women under 35 have reasonably good outcomes.
Good Response to Ovarian Stimulation
Women who respond well to fertility drugs and produce many eggs during IVF often maintain better ovarian reserve afterwards.
Use of Frozen Embryos
Transfer of frozen embryos from previous IVF cycles offers another opportunity for pregnancy without further treatment.
Allowing Time Between IVF Cycles
Giving the body a chance to rest and recover for several months between IVF treatments may optimize natural fertility.
Supportive Healthcare Team
Having an encouraging doctor who monitors fertility potential and provides emotional support maximizes the chances of conception through natural cycles or further treatment.
Supportive Techniques to Try Post-IVF
Some fertility-friendly lifestyle changes and integrative techniques may support natural conception abilities after IVF as well. Options to consider include:
Fertility Diet
Eating a diet rich in fertility-boosting foods can help create a supportive hormonal environment. Key nutrients include protein, iron, zinc, antioxidants, and healthy fats.
Exercise
Regular moderate exercise enhances overall health and reproductive functioning. But too intense of exercise can disrupt menstrual cycles.
Fertility Massage
Massage techniques like Maya abdominal massage can increase blood flow to reproductive organs. This may help nourish eggs and optimize natural fertility.
Fertility Acupuncture
Acupuncture may help regulate hormones, reduce stress, and address conditions contributing to infertility. More research is needed on the efficacy of acupuncture post-IVF.
Trigger Point Release
Massaging trigger points in the abdominal area may promote blood flow and circulation to impaired reproductive structures. However, evidence is limited.
Herbal Remedies
Some herbal preparations claim to support reproductive function. But safety and effectiveness are questionable. It is essential to discuss any herbs with your physician.
Mind-Body Practices
Yoga, mindfulness, meditation, and hypnotherapy help reduce stress and anxiety. This fosters a calmer state supportive of natural conception.
When to Consider Further Fertility Treatment
The longer couples attempt natural conception after IVF with no success, the lower their chances typically become. It is reasonable to pursue natural cycles for 6 months to a year post-IVF. But if pregnancy is not achieved in that timeframe, it may be time to consider additional treatment. Further options may include:
- More IVF with fresh embryos
- IVF with frozen embryos from previous cycles
- Donor eggs or sperm
- Surrogacy
- Tubal surgeries to repair structural issues
- Artificial insemination procedures like IUI
- Fertility drugs with timed intercourse
- Adjuvant therapies to support IVF success
New IVF cycles with a modified protocol, improved embryo testing, and fertility medications may achieve success where prior IVF attempts have failed. Each couple’s individual fertility diagnoses guide the ideal treatment plan.
Natural Pregnancy Chances After IVF By Age
A woman’s age when attempting natural conception after IVF strongly influences her chances of success. Younger women have the best prognosis. Here are approximate natural pregnancy success rates by female age bracket:
| Age During IVF Cycles | Chances of Natural Pregnancy After IVF |
|---|---|
| Under 35 | Around 30% – 40% |
| 35-37 | Around 20% – 30% |
| 38-40 | Around 10% – 15% |
| Over 40 | Around 5% |
These pregnancy rates account for the age-related fertility decline. The number of prior failed IVF cycles also impacts natural conception potential. Younger women who have done 1-2 IVF attempts tend to have the best chances.
Other Considerations for Getting Pregnant After IVF
A few other considerations exist when trying for pregnancy after IVF, including:
Need for STI Testing
If a couple engages in intercourse outside of IVF while trying naturally, STI screening is recommended first. STIs can impact fertility.
Effectiveness of Ovulation Prediction
Hormonal fluctuations after IVF may make ovulation harder to pinpoint. Tools like ovulation predictor kits (OPKs) and basal body temperature (BBT) tracking can maximize timing of intercourse.
Role of Intrauterine Inseminations
IUI is less invasive than IVF and may enable pregnancy with less cost and medication need. It places sperm directly into the uterus. Talk to your doctor about trying IUI.
When to Use Fertility Drugs
Medications may stimulate ovulation or support implantation in natural cycles. Clomiphene citrate and letrozole are two common options.
Value of Tracking Cervical Mucus
Monitoring cervical mucus changes helps identify the most fertile window for conception. This favorable mucus supports sperm motility.
Handling Emotional Challenges
Dealing with the rollercoaster of hope and grief when natural cycles fail after IVF takes an emotional toll. Having a strong support system is invaluable.
Key Takeaways
Some important key takeaways about fertility after IVF include:
- Getting pregnant naturally is possible for many couples after IVF treatment.
- Conception rates tend to be lower than expected fecundity rates in fertile couples.
- Around 30% conceive within 6-12 months after 1 IVF cycle.
- Conception is less likely after multiple IVF cycles, especially at advanced maternal ages.
- Secondary infertility is more common after IVF versus no treatment.
- Younger age, few IVF attempts, and male factor infertility optimize fertility potential.
- Trying natural cycles for 6-12 months post-IVF is recommended.
- More IVF or other assisted reproductive technologies may be pursued if pregnancy is not achieved naturally in that timeframe.
Conclusion
While fertility may be somewhat decreased after IVF treatment, natural conception remains possible, particularly for younger women with fewer IVF attempts. Couples should ideally give natural cycles a try for several months after discontinuing IVF. However, those facing advanced age or multiple failed IVF rounds may wish to pursue additional treatments sooner. Working with a reproductive endocrinologist helps determine the ideal plan for attempting pregnancy after IVF based on each couple’s unique history and fertility factors. With an individualized approach, many couples can successfully build their families, whether through natural conception or further assisted reproductive methods. The key is being proactive and exploring all options.
