Success rates are often the first thing people search for when they start thinking about IVF — and often the most misunderstood. This article explains what the numbers mean, what affects them, and what to realistically expect from IVF in South Africa.
Why South Africa Doesn’t Have Published National Data
Unlike the UK (where the HFEA publishes annual clinic-by-clinic outcomes) and the USA (where SART and the CDC publish national data), South Africa does not have a national fertility outcomes registry. The South African Society of Reproductive Medicine (SASREG) does not publish aggregate outcome statistics publicly.
This means South African couples often have to rely on international data to set realistic expectations — or ask their clinic directly for their own statistics. The international data is broadly applicable to SA’s leading private centres, which use equivalent protocols and laboratory standards.
What ‘Success Rate’ Actually Means
When clinics quote success rates, they may be referring to different things. The most meaningful measure is live birth rate per embryo transfer (or per started cycle). Clinical pregnancy rate is higher — it counts heartbeats on early ultrasound, not babies born. Always ask which metric you are being quoted.
| A 40% success rate means that in 100 cycles, 40 women will carry a baby to birth. 60 will not. This is not failure — it is the honest reality of IVF statistics, and it affects how you prepare emotionally. |
IVF Success Rates by Age (SA-applicable international data)
Age is the strongest predictor of IVF outcome. The following data is from ESHRE European registry data and ASRM-cited studies — applicable to SA’s private sector:
- Under 35: approximately 35–45% live birth rate per embryo transfer
- Age 35–37: approximately 25–35% per transfer
- Age 38–40: approximately 15–22% per transfer
- Age 41–42: approximately 8–13% per transfer
- Over 42 with own eggs: typically below 5% — donor eggs recommended
- Using donor eggs: success rates are determined by the donor’s age at egg retrieval, not the recipient’s age — typically 40–55% per transfer
Cumulative Success — The More Useful Number
Most people pursue more than one IVF cycle. Cumulative success rates over multiple cycles are higher and more meaningful for planning:
- After 3 cycles: approximately 50–65% cumulative live birth rate for women under 35 (ESHRE data)
- After 6 cycles: approximately 54–77% (ASRM/UNSW cited data)
These figures decline with age. For women over 40 using own eggs, cumulative rates are significantly lower, and donor egg IVF is often the most effective pathway.
What Affects Success Rate Beyond Age
- Ovarian reserve (AMH and AFC): low reserve reduces egg yield per cycle
- Sperm quality: poor DNA fragmentation affects fertilisation and embryo development even with normal semen analysis
- Embryo quality: assessed by the embryology team during development — not visible to patients until results are shared
- Uterine receptivity: polyps, fibroids, or adhesions affect implantation
- BMI: both underweight and obesity are associated with reduced IVF outcomes (ESHRE data)
- Clinic laboratory quality: embryology expertise, air quality systems, and incubator environment vary between clinics
- Number of cycles: as shown by cumulative data, persistence within medically appropriate parameters increases overall chances
A Note on Clinic-Quoted Statistics
Be cautious of success rates quoted without context. A clinic reporting ‘65% success rate’ may be:
- Counting clinical pregnancies rather than live births
- Including only ideal-prognosis patients
- Reporting from selected cycle types (e.g., donor eggs only)
- Using outdated data
The most reliable question to ask a SA clinic is: ‘What is your live birth rate per embryo transfer, for women in my age group, using my own eggs?’ Followed by: ‘How many cycles did this data cover?’
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| KEY TAKEAWAYS |
| ✓ SA does not publish national IVF outcome data — international data from ESHRE and ASRM applies to SA’s private sector. |
| ✓ Under 35: approximately 35–45% live birth rate per transfer. The rate declines significantly with age. |
| ✓ Cumulative success across multiple cycles is higher — planning for more than one cycle is realistic. |
| ✓ Clinic-quoted success rates require context — always ask which metric and what patient population. |
| ✓ Donor egg IVF success rates are determined by the donor’s age, not the recipient’s — typically 40–55% per transfer. |
References
- ESHRE (2023). ART in Europe register data.
- ASRM/SART (2024). IVF outcomes data.
⚕ Medical Disclaimer: This content is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before making any decisions about fertility treatment.
