IVF and Pregnancy Rates: A Closer Look
Over the past several months, I have received increasing numbers of inquiries from patients regarding pregnancy rates in our IVF program relative to other programs. IVF pregnancy rates have been reported to the Society of Assisted Reproductive Technology since 1984, published by the CDC since 1996, and are available online.
In our competitive environment, programs often publish their "pregnancy rates" in mailed materials or via the internet. There is no question that this data is of great interest to couples and also little doubt there is poor understanding of the limitations of this data. The term "pregnancy" rate (pregnancy/ cycle) can have multiple meanings. Does "pregnancy" refer to chemical, ectopic, clinical, ongoing or delivered pregnancies? Does "cycle" include all initiated cycles, initiated minus canceled cycles or cycles only involving an embryo transfer? Programs that quote rates without definition provide no meaningful data. SART specifically highlights live births per initiated cycles. SART cautions "A comparison of clinic success rates may not be meaningful because patient medical characteristics and treatment approaches vary from clinic to clinic." I agree.
Some of the variables among IVF clinics:
Pre-IVF
- Degree of insurance coverage
- Day 3 FSH levels
- Interpretation of semen analysis parameters
- Duration of infertility
- Number of previous ovulation induction cycles
- "Difficult" vs. "easy" patients
IVF
- Stimulation techniques
- Monitoring
- Oocyte retrieval
- Embryology laboratory
- Number of embryos transferred
- Day 3 vs. Day 5 transfer
- Transfer technique
The most recently published CDC studies show our rates (live birth/initiated cycle) to be among the highest in the country and have increased in the two subsequent reporting years. Our goal is a well-educated professional and lay community. We want patients to understand their options in a non-pressured environment and to make truly informed decisions as to their care. While we take pride in our IVF success rates, we provide an individualized approach to treatment, acknowledging that for many couples less invasive treatments may provide a successful outcome. Please let us know if we can be of assistance.
Dr. Eric Silverstein
Medical Director