When choosing an infertility clinic we have little to go on other than word of mouth and the Infertility Clinic Success Statistics compiled by the US Centers of Disease Control (CDC). The devil, as always, is in the details. The problem with the statistics, as wonderful as they are, is wading through the sea of numbers to figure out which ones are meaningful to you. You can look up your fertility clinic’s IVF success rates by going to the CDC site, entering your state, and selecting your clinic. Much can be learned by comparing a specific infertility clinics statistics to the national averages for IVF success, pregnancy rates, numbers of embryos transferred, and twin rates. Note that these statistics are only for IVF, and do not cover IUI success rates.
The numbers can look overwhelming at first, but listen to yesterday’s Creating a Family show for a great explanation of what each statistic means and which ones are most relevant to patients. Our guest experts were Dr. Laurence Udoff, a reproductive endocrinologist with Genetics and IVF Institute and a professor at University of Maryland. He is the lead physician at GIVF on Donor Egg IVF and egg vitrification. We also had Dr. David Adamson, reproductive endocrinologist and Medical Director of PAMF Fertility Physicians of Northern California and Founder and CEO of Advanced Reproductive Care, a national network of fertility clinics. He was past President of the American Society for Reproductive Medicine (ASRM), and the Society for Assisted Reproductive Technologies (SART). They were top notch an>d wonderfully frank.
The Downside to the IVF Success Statistics
While I think the Infertility Clinic In Vitro Fertilization Success Rate statistics are a wonderful asset, they give meaning to Mark Twain’s quip that there are lies, damned lies, and then there are statistics. As Drs. Adamson and Udoff explained on the show, these IVF stats can drive treatment decisions that arguably may not be in the individual patients best interest. Further, they may not be a good representative of what is really happening. Often there is a perfectly good explanation for an unusually high or low statistic. Dr. Udoff gave the example of a clinic with an unusually high IVF cycle cancellation rate. Turns out that most of the patients in this practice had the same insurance that covered three in vitro fertilization cycles. Bizarrely, the insurance did not consider it “a cycle” to be counted against the lifetime max of three cycles until after egg retrieval. This fertility clinic was willing to “mess up” their statistics to work with patients by canceling cycles before egg retrieval when not enough eggs were produced.
Another example of statistics possibly influencing fertility treatment practice is when some clinics refuse to accept patients with low probability of success or only accepting woman over 40 if they agree to go straight to donor egg. A case could be made that this is just good medicine since older woman have low odds of success, but many women will accept the risk and cost of failure to try at least one round of IVF with their own eggs just to know that they tried.
Did you check your infertility clinic IVF success rate before choosing?
Image credit: Chris.T. (Eng)
Our recent research study shows even the official SART reporting system for IVF pregnancy rates can be manipulated.
Some clinics artificially inflate their rates by finding loopholes in the federal reporting guidelines.
You can read the full report here:
Here
Fascinating study. Thanks for including the link.
Dawn, I view the CDC/SART stats as simply a starting point – one piece of data to be considered when selecting a clinic. And unfortunately, the fact that they are reporting live birth rates from two years ago, means that aside from everything else, the data is frankly OLD!
There are a few areas where the CDC/SART just aren’t providing stats currently though and I think it is causing confusion. That is in frozen donor eggs (or frozen eggs period) and frozen transfers after PGS/CCS where the first transfer of the cycle is frozen, and frozen donated embryos.
Regarding statistics for frozen eggs/egg banks it is hard to compare apples to apples when there are no set standards for the reporting. You may find that some banks/clinics include cumulative success rates per batch rather than transfer (meaning if a patient has success on any try from a batch of frozen eggs), or some might combine stats across several years. Also, the numbers for frozen eggs at some clinics are still low, so its hard to know statistical relevance if there simply aren’t enough cycles.
The other missing link IMHO is stats for frozen transfers after PGS/Comprehensive Chromosome screening when the embryos are biopsied, frozen and there was no fresh transfer. More and more patients are using CCS testing on embryos and freezing then transferring in a frozen cycle. Combining it with other non-CCS frozen transfers doesn’t seem quite right. I think it should be a separate reporting category.
Frozen donated embryos are a whole separate category that is largely overlooked by CDC/SART. Last I checked, there were no good/verified statistics for embryo donation.
Hopefully the statistical reporting will catch up with the technology some day, but of course by then we’ll be asking for statistics on even newer technologies that have been introduced.
Sue, such good points. We talked about this with Drs. Adamson and Udoff. The CDC stats are 3 years old and the SART stats are 2 years old.