IVF cumulative live birth calculator
Estimates the cumulative chance of at least one live birth from a single egg collection, following the chain AFC → eggs collected → MII (mature) eggs → blastocyst → euploid blastocyst → live birth. Ovarian response is set from the antral follicle count (AFC) via the follicle–to–oocyte index (FOI); maturity, euploidy and blastulation are literature-based and adjustable.
Inputs
Results (at selected blastulation rate)
Funnel — number at each stage
| Stage | Number | 95% CI |
|---|---|---|
| Antral follicle count (AFC) | — | — |
| Eggs collected | — | — |
| MII (mature) eggs | — | — |
| Blastocysts | — | — |
| Euploid blastocysts | — | — |
| Expected live births | — | — |
| Cumulative chance of ≥1 live birth | — | — |
| Cumulative chance of ≥2 live births | — | — |
| Cumulative chance of ≥3 live births | — | — |
Sensitivity: blastulation per MII oocyte (25–55%)
| Blast/MII | Expected euploid | Expected live births | Cumulative P(≥1 LB) |
|---|
Cycles to reach a target chance
| Egg collections | ≥1 live birth | ≥2 live births | ≥3 live births |
|---|
References — AFC, FOI, oocyte maturity, euploidy & blastulation
Euploidy and per-euploid clinical pregnancy default to the clinic’s own Care London 2025 PGT-A audit (ref 1). Ovarian response is anchored to the follicle–to–oocyte index (FOI = oocytes retrieved ÷ AFC) of Alviggi/POSEIDON, with FOI >0.5 taken as normal ovarian sensitivity and ≤0.5 as suboptimal (hypo-) response. Band cut-offs use the POSEIDON 0.5 threshold and the 4,323-cycle tertiles (≤0.70 / 0.71–0.95 / 0.96–1.00). The default MII maturity (85%) is consistent with the ovarian-yield data (MII/AFC 0.68 vs oocytes/AFC 0.82 ≈ 83%). The age-based blastulation curve is expressed per MII oocyte, calibrated from the Fertility & Sterility usable-blastocyst-per-oocyte age data (35.7% at <30 → 14.5% at ≥43) at ~85% reference maturity, so that at 85% maturity the overall egg→blastocyst yield matches the prior version.
| # | Study / source | Dataset size | Key finding |
|---|---|---|---|
| 1 | Care London 2025 PGT-A audit (CAM meeting, 14 Jul 2026) | 1,804 biopsied blastocysts; 295 euploid transfers (2025, own eggs, excl. TBR) | Euploidy by age 66.1% (<35) → 55.8% → 44.7% → 31.2% → 19.4% (>42); CPR per euploid transfer 63.7% overall (67.5% <35 … 54.4% 40–42; per-age samples small). |
| 2 | Alviggi et al. FORT & FOI / POSEIDON, Front. Endocrinol. 2019 | Concept paper | Defines FOI = oocytes retrieved ÷ AFC; FOI >0.5 = normal ovarian sensitivity, ≤0.5 = suboptimal response despite adequate reserve. |
| 3 | FOI & clinical pregnancy, Front. Endocrinol. 2022 | 4,323 fresh transfer cycles | FOI tertiles ≤0.70 / 0.71–0.95 / 0.96–1.00; clinical pregnancy rises across bands (47.3% → 51.8% → 51.6%); +1 SD FOI → ~20% higher CPR. |
| 4 | FORT & FOI by POSEIDON group, Front. Endocrinol. 2020 | 32,128 treatment cycles | Mean FOI across POSEIDON groups 0.62–1.07; low ovarian sensitivity defined as FOI ≤0.50. |
| 5 | Ovarian yield (oocytes & MII per AFC) & live birth, Front. Med. 2021 | Large IVF cohort | Oocytes/AFC 0.82 vs 0.71 and MII/AFC 0.68 vs 0.57 in live-birth vs no-live-birth groups; higher yield ratios predict live birth (implied MII maturity ≈ 83%). |
| 6 | Mature oocyte proportion & IVF success, J Reprod Infertil | 2,565 ICSI cycles | Live birth 7.5% (≤50% MII) vs 21.5% (51–75%) vs 22.9% (76–100%); maturity >50% an independent predictor of pregnancy. |
| 7 | Setti et al. 2022, Andrologia | 21,960 oocytes / 3,837 ICSI cycles | Paternal ageing independently impacts blastulation, interacting with maternal age. |
| 8 | AI blastocyst prediction, Hum. Reprod. 2025 | 12,940 MII-oocyte images / 1,438 patients | Blastocyst rate per inseminated (MII) oocyte 50.0% autologous (age 36.5) vs 65.0% donor (age 26.6). (anchor for per-MII curve) |
| 9 | Usable blastocyst dev. rate, Fertility & Sterility | Large extended-culture cohort | Usable blastocyst rate per oocyte falls with age (35.7% <30 → 14.5% ≥43); ultra-low O₂ improves it. (anchor for age curve) |
| 10 | Oocyte maturity multicenter study, J IVF-Worldwide | Multicenter retrospective | Oocyte maturity (MII) rate is an age-independent predictor of blastocyst development and euploidy. |
| 11 | Duke Fertility Center 2013–2017, MEFS Journal | 1,005 cycles / 11,022 oocytes | Overall blastulation 70%; not sig. affected by maternal age; lower with surgical sperm (59.2%); physician effect up to 7.6%. |
| 12 | Culture media & aneuploidy, PMC | 866 IVF cycles | Single-step media: blastulation 51.7% vs 43.4% sequential (but higher aneuploidy). |
Methods & assumptions
The calculator models a single egg collection as a chain and reports the cumulative chance of at least one live birth:
eggs = AFC × FOI; MII = eggs × maturity; P(≥1 live birth) = 1 − (1 − p)MII, where p = blastulationper MII × euploidy × live birth per euploid
- AFC → eggs (FOI). The follicle–to–oocyte index (FOI = oocytes retrieved ÷ AFC) sets expected yield. In project mode you pick an FOI band (or fine-tune the FOI); in actual mode you enter the eggs collected and the FOI & band are computed. FOI >0.5 is normal ovarian sensitivity; ≤0.5 is a suboptimal/hypo-response despite adequate reserve (Alviggi/POSEIDON).
- Eggs → MII. Only mature (metaphase-II) oocytes are fertilised and cultured. Maturity defaults to 85% (consistent with MII/AFC ≈ 0.68 vs oocytes/AFC ≈ 0.82) and is adjustable; outcomes fall sharply below ~50% maturity.
- MII → blastocyst. Blastulation is expressed per MII oocyte. The age-based default is calibrated from the Fertility & Sterility usable-blastocyst-per-oocyte age data at ~85% reference maturity, so at 85% maturity the egg→blastocyst yield matches the prior version; it can be overridden manually.
- Euploidy defaults to the Care London 2025 PGT-A audit by age band (66.1% <35 → 19.4% >42); CRGH 2016–18, Reprogenetics 2017 and their blend remain selectable.
- Per-euploid outcome defaults to the Care London 2025 clinical pregnancy rate (63.7% all ages, or age-specific) converted to live birth by an adjustable live-birth-per-clinical-pregnancy factor (default 87%); a manual live-birth rate is also selectable. Per-age CPR samples are small, so the audit advises quoting the all-ages figure.
- Paternal age is informational by default; the optional strength control applies a maternal-age-scaled reduction to the live-birth step (Setti et al. 2022) and does not alter euploidy, which is maternal in origin.
Key limitations: figures are population averages, not individual predictions; each MII oocyte is treated as statistically independent; FOI, maturity, euploidy and blastulation are modelled as independent multiplicative steps; embryo quality, mosaicism, endometrial and clinical factors are not modelled. Individual results vary considerably.