Calculating cumulative live-birth rates from linked cycles of assisted reproductive technology (ART): data from the Massachusetts SART CORS

Objective: To determine the feasibility of linking assisted reproductive technology (ART) cycles for individual women to compare per-cycle and cumulative live-birth rates.

Design: Historical cohort study.

Setting: Clinic-based data.

Patient(s): A total of 27,906 ART cycles with residency or treatment in Massachusetts during 2004-2006 and reported to the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System (SART CORS) on-line database.

Intervention(s): None.

Main outcome measure(s): Per-cycle and cumulative live-birth rates.

Result(s): Linkage of cycles up to and including the first live-birth delivery revealed 14,265 women who averaged 1.9+/-1.2 SD cycles (range 1-11). These cycles yielded 9,452 pregnancies resulting in 7,675 live-birth deliveries. From cycle 1 to cycle 4, the cumulative live-birth rate for all patients increased from 30.4% to 43.3%, 49.1%, and 51.9%, respectively, and plateaued thereafter at about 53%. The cumulative live-birth rate after three cycles using donor oocytes was approximately 60% for women aged<43 years and >50% for women>or=43 years; for autologous oocytes it was 60.1% for ages<35 years and declined steadily to 8.5% for ages>or=43 years.

Conclusion(s): The results demonstrate the feasibility of linking ART cycles for individual women from SART CORS to characterize cumulative live-birth rates.