Indications for in vitro fertilisation: changing trends: the Norfolk experience.

From January 1987 to December 1990, 1,415 patients were enrolled for in vitro fertilisation (IVF), series 26-41, at the Jones Institute for Reproductive Medicine. They underwent 2,393 IVF cycles. The most common indications were tubal factor (57.3%), male infertility (22.0%), endometriosis (10.9%), and idiopathic infertility (5.2%). This represented a significant decrease in the proportion of cycles performed for tubal disease and an increase in the proportion of cycles performed for male infertility as compared with the earlier series 1-16, 1981-1984. Total pregnancy rates from fresh transfers remained stable for most indications, being the lowest for diethylstilbestrol (DES) exposure (16.7%), and highest for immunologic infertility (47.6%). In addition, patients with polycystic ovarian disease (PCOD) had a high pregnancy rate (47.2%) from fresh transfers but a high first trimester abortion rate as well (19.4%). The ongoing pregnancy rate from fresh transfers for the whole population was around 19.0%, being highest for patients with immunologic infertility (31.8%) and lowest for DES exposed patients (9.3%). The cumulative ongoing pregnancy rate to date for the whole population from fresh and cryopreserved embryos was 21.6% per embryo transfer (range from 13.3% for DES patients to 33.3% for immunologic infertility). The projected ongoing pregnancy rate as obtained from adding the number of cumulative pregnancies to date to the number of predicted ongoing pregnancies calculated from the remaining frozen embryos was 23.9% for the whole population (range 16.7% for DES patients to 33.3% for immunologic infertility).(ABSTRACT TRUNCATED AT 250 WORDS)