Only women’s age and the duration of infertility are the prognostic factors for the success rate of natural cycle IVF

  • Michael von WolffEmail author
  • Alexandra Kohl Schwartz
  • Norman Bitterlich
  • Petra Stute
  • Monika Fäh
Gynecologic Endocrinology and Reproductive Medicine



It is controversial who should be recommended to undergo natural cycle IVF (NC-IVF). Therefore, objective prognostic criteria which are already known at the time of counselling were defined.


A retrospective observational study was performed with 201 couples (age 34.7 ± 4.1) undergoing 311 NC-IVF treatments with 201 transfers, corresponding to a transfer rate of 65.3%. The first cycle resulting in a transfer of one embryo was further analysed. Clinical pregnancy and live birth rates were analysed.


Pregnancy rate and live birth rates per first cycle were 21.9% and 13.2%, respectively. Groupwise comparison revealed the following clinical pregnancy/live birth rates per transfer cycle: duration of infertility 1–2 years 34.3/25.7%, 3–4 years 21.8/14.9% and > 4 years 9.1/4.5%. Women’s age  < 34 years 26.3/22.4%, 34–37 years 25.7/18.9% and 38–42 years 15.7/3.9%. Linear regression analysis showed that pregnancy and live birth rate correlated negatively with the duration of infertility and that live birth rate but not pregnancy rate correlated negatively with increasing female age. In contrast, AMH and infertility factors did not correlate with the success rate. Statistically significant correlations remained if a multivariate logistic regression analysis was performed, supporting further that the duration of infertility (OR 0.61, 95% CI 0.42–0.86) (P = 0.006) and female age (OR 0.87, 95% CI 0.78–0.95) (P = 0.008) are the predictors for live birth rates in NC-IVF transfer cycles.


Based on the success rates, NC-IVF can especially be recommended for women with short duration of infertility and young age, whereas older women and those with long duration of infertility are not the best candidates for this technique.


Pregnancy rate Live birth rate Natural cycle IVF Prognostic factors Age 



We would like to thank Dr. Elizabeth Kraemer for the linguistic revision and correction of the manuscript.

Author contributions

MvW: design of the study, analysis of data and writing of the manuscript. AKS: preparation of data. NB: statistics. PS: preparation of data. MF: preparation of data. All authors contributed to the manuscript revision, read and approved the submitted version.


This study was not funded.

Compliance with ethical standards

Conflict of interest

None of the authors have declared a conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Gynaecological Endocrinology and Reproductive MedicineUniversity Women’s Hospital, Inselspital, University HospitalBernSwitzerland
  2. 2.Medizin and Service GmbHChemnitzGermany

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