How effective is assisted reproduction technology?
GROUND: All conceptions occurring after a treatment for infertility are usually attributed to the treatment. This is only true when only totally sterile couples are treated: subfecund couples may still conceive without treatment. METHODS: We used a computer simulation (Monte Carlo) model of reproduction, combining the monthly probability of conceiving, the risk of miscarriage and the probability of age dependent permanent sterility. After a delay (D) without conceiving, the couples are assumed to turn to assisted reproduction technology. The treatment increases the fecundability (monthly rate of conception) of subfecund couples and restores the fertility of some totally sterile couples. The overall effectiveness of the therapy is based on data (by age of women) for two attempts of IVF. The number of conceptions ending in a live birth with ART is compared to the number of conceptions after one or two additional years without ART. RESULTS: At 30 years of age, the crude effectiveness of A
