What Does a “Round” or “Cycle” of IVF Even Mean?

  • If you have an egg retrieval and zero transfers, that’s one cycle of IVF.
  • If you have an egg retrieval and one transfer, that’s one cycle of IVF.
  • If you have an egg retrieval and four transfers, that’s one cycle of IVF.

A “cycle of IVF” and a “round of IVF” are synonymous.

A round (AKA a cycle) of IVF is pegged to the number of egg retrievals and not the number of transfers. Going through an egg retrieval and zero transfers, or going through an egg retrieval and five transfers, are both considered “one cycle of IVF.” So if the number of cycles of IVF is just how many retrievals you do, why don’t we just call it egg retrievals instead of cycles?

The definition around the world

There are some inconsistencies in the definition around the world, too. A friend of mine in Singapore said they count the number of transfers as the number of cycles. So one egg retrieval with three transfers would be three rounds. But what if it takes you multiple retrievals to get any embryos to transfer? It feels like this would be undercounting the experience for those women.

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What about frozen embryo transfers (FET)?

So if a round of IVF is just the number of egg retrievals, how do we count the transfers? Most clinics today only do frozen embryo transfers (FET) versus a fresh transfer. This is the part of IVF where a frozen embryo is placed in the womb, french fries are consumed, and all fingers and toes are crossed until you can take that pregnancy test.

What about a cancelled cycle?

Approximately 10% of cycles are cancelled before the egg retrieval. This generally occurs due to inadequate egg production (84% of cancelled cycles) or hyper-responsiveness (4% of cancelled cycles) and is strongly associated with age. I have had two cancelled cycles due to low follicle count and fibroids. Because this was before the stims started, I don’t count these cancelled cycles as a round of IVF. But what if a cycle is cancelled last minute before the retrieval? Should that be counted as a cycle? The answer isn’t clear.

My suggestion: a new way to keep IVF score

If we want a clear and consistent way to describe our IVF journeys, I propose we develop a new way to talk about our experience. Let’s count every retrieval and every transfer that we’ve incurred. We can use the total number, along with parentheses that indicate (retrievals + transfers). So:

  • If you have an egg retrieval and zero transfers, that’s IVF x 1 (1+0)
  • If you have an egg retrieval and one transfer, that’s one cycle of IVF X 2 (1+1)
  • If you have an egg retrieval and four transfers, that’s one cycle of IVF X 5 (1+4)

Does it even matter?

Sometimes it feels like we are competing for who is the most infertile, and admittedly, having stats on our infertility can feel a little icky. But, for the new kids in the room, it’s important to help set expectations that IVF is rarely one and done (read more in my article, The IVF Funnel: Understanding Your Chances of Success). And having a universal understanding of what it means when someone says they’ve gone through “12 rounds of IVF” is only helpful.

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