Below: Relationship between the female age at which couples start building a family and the chance of realizing a family with two children, with and without use of IVF. The short lines above and below each point in the graph indicate the 95% confidence intervals.
Below: Relationship between the female age at which couples start building a family and the chance of realizing a family with three children, with and without use of IVF. The short lines above and below each point in the graph indicate the 95% confidence intervals.
In order to have a chance of at least 90% to realize a one-child family, couples should start trying to conceive when the female partner is 35 years of age or younger, in case IVF is an acceptable option. For two children, the latest starting age is 31 years, and for three children 28 years. Without IVF, couples should start no later than age 32 years for a one-child family, at 27 years for a two-child family, and at 23 years for three children. When couples accept 75% or lower chances of family completion, they can start 4–11 years later. The results appeared to be robust for plausible changes in model assumptions.
Our conclusions would have been more persuasive if derived directly from large-scale prospective studies. An evidence-based simulation study (as we did) is the next best option. We recommend that the simulations should be updated every 5–10 years with new evidence because, owing to improvements in IVF technology, the assumptions on IVF success chances in particular run the risk of becoming outdated.
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