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MADELEINE BRAND, host:

This is Day to Day. I'm Madeleine Brand.

ALEX COHEN, host:

I'm Alex Cohen. In a few minutes, Michelle Obama's daytime dress - was it bold or dowdy? A critique of inaugural fashion.

BRAND: But first, a lot of couples try in vitro fertilization if they're having trouble getting pregnant. IVF is both uncomfortable - lots of injections - and costly. Until now, there was no way of telling how many times you should do it if the first try is unsuccessful. Now, a new study in the New England Journal of Medicine says it takes three to six cycles. NPR's Patti Neighmond reports.

Unidentified Woman #1: OK. So, I'm going to give you some more blankets.

Unidentified Woman #2: Thank you. I'm just shivering, and it's not too comfortable right now.

Unidentified Woman #1: OK. Here are some more blankets. How's your belly feeling?

Unidentified Woman #2: Sore.

PATTI NEIGHMOND: This patient is undergoing a procedure to help her get pregnant. She's at Boston IVF, one of the nation's largest fertility clinics. In vitro fertilization is a procedure where women take hormones to stimulate ovulation. Doctors then mix the eggs and sperm in the petri dish and create embryos which are inserted into the woman's uterus. The big question is whether those embryos attach and a pregnancy results. Dr. Alan Penzias of Boston IVF treats infertile women.

Dr. ALAN PENZIAS (Reproductive Endocrinologist, Boston IVF): The single question that they really want to know, how likely are they, when all is said and done, to have a baby? Unfortunately, most of the work that's been done before and even the individual statistics hasn't been able to answer that question, and now we can.

NEIGHMOND: Now, Penzias, who is also a professor at Harvard Medical School, has figured out how many IVF cycles it took women to become pregnant and have babies and how much each individual cycle increased their odds. Over a five-year period, Penzias and colleagues analyzed over 6,000 patients undergoing over 14,000 cycles of IVF.

Dr. PENZIAS: With this new information, by looking at this study in this way, I can sit across today from a 32-year-old patient and tell her that if she goes through up to six IVF cycles, she has somewhere between a 65 and 86 percent chance of having a baby at the end of therapy.

NEIGHMOND: Before this, fertility specialists couldn't do that. They could only predict the odds of having a baby after each individual cycle of IVF, which was about 40 percent for a patient under 35. Penzias says the results of his study should convince women that if IVF fails once or twice, that doesn't mean they'll never get pregnant and have a baby. An 85 percent chance after six cycles of IVF, he says, is pretty high, confirming the old adage that try and try again is a good idea.

Ms. ILANA CHUNG (ph): Not yet.

Ms. REBECCA CHUNG (ph): Six, seven.

NEIGHMOND: A game of hide and seek begins in earnest for Rebecca Chung and her daughter. Chung is on her sixth IVF attempt to produce a sibling for four-year-old Ilana.

Ms. REBECCA CHUNG: Are you hiding on the bottom shelf? No. Then I have to look in the bathroom. There you are.

Ms. ILANA CHUNG: I couldn't fit in the bottom shelf.

Ms. REBECCA CHUNG: When she was about two years old, we decided it was time to try for a sibling. And thus began our rollercoaster for the last two and a half years. We had a bunch of close calls. I got pregnant several times, but never with the happy result of a sibling for my daughter.

NEIGHMOND: Chung's typical of younger people, those under 40, with infertility. Her husband's sperm count is low, and she doesn't ovulate regularly. But in one sense, she says she's lucky. Chung lives in Massachusetts, a state, which like New Jersey, mandates insurance coverage of IVF. Most states don't. And IVF is expensive, ranging anywhere from seven to fifteen thousand dollars per cycle depending on where you live.

Ms. REBECCA CHUNG: We're actually on our last try right now. If that doesn't work - of course, I hope it does otherwise, or I wouldn't keep trying - but if that one doesn't work, then I've actually - I've never been against adoption, but I always thought it would be fun to have two babies and then adopt to. So we'll probably consider adoption.

NEIGHMOND: At 36, Dr. Penzias says Rebecca Chung is still young and her chances are good that IVF will eventually work. The chances aren't so good for women over 40. While IVF can boost their odds to those of fertile women over 40, it can't reverse the clock, says Penzias. In his study, women over 40 had half the chance of having a baby as younger women under 35. Patti Neighmond, NPR News.

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