IVF Success Rates
Patients often use national reporting of clinic-specific pregnancy rates to assess the quality of an infertility center’s program. Unfortunately, comparing these “success rates” can be complicated. What patients often do not know is that a report showing high pregnancy rates per cycle can either mean success – or something totally different.
Success Rates: Terminology
To boost success rates, some centers may exclude less than ideal candidates or recommend in vitro fertilization to patients who would otherwise conceive with simpler approaches. They also can choose to exclude patients who have a less than ideal prognosis with IVF (such as patients older than age 35, FSH levels greater than 9, patients who smoke, patients with only one ovary, and patients with severe male factor infertility). Centers with fewer numbers of overall cycles may in fact be carefully selecting certain patients to help ensure high pregnancy rates.
Pregnancy rates are quite important to both the clinician and the patient. However, as noted above, it can be difficult to compare pregnancy rates between clinics and across the country because of a variety of different fertility diagnoses, ages and prognosis. Pregnancy rate reports by SART are done so two years after they occur and many clinical changes can occur in the interim. At CRM we are holistic and inclusive in our delivery of care. We do not exclude women based upon age, ovarian reserve or prior cycle history. We do attempt to provide them with appropriate clinical guidance and expertise through their journey. In addition, we are an incredibly innovative practice and keep up with the latest technology. Therefore we have are continually refining our protocols to optimize outcomes.
At the Center for Reproductive Medicine (CRM), we adhere to the highest ethical standards, educating our patients about their disorder and recommending the most cost effective treatment. Quality for us is a satisfied patient who understands their condition and its treatment, feels that the best advice was given and that the treatment, if indicated, was attempted with the best possible medical supervision and service.
Comparing IVF success also demands a strict definition of terms. The term “pregnancy" can have various connotations, from positive pregnancy test to live born delivery. The term “biochemical pregnancy” indicates that the embryo has implanted with a rise in the pregnancy hormone (beta hCG) level with early loss prior to visualization on ultrasound. A “clinical pregnancy” must at least progress to the point where a pregnancy sac and fetal heart activity may be documented on ultrasound. “Ongoing pregnancies” are those pregnancies which proceed toward term, minus any miscarriages.
Pregnancy rates may be expressed per IVF cycle started, per egg retrieval, or per embryo transfer procedure.
The most frequent complication of IVF has been multiple gestation. Prior to the advent of blastocyst culture and transfer, approximately 30% of IVF pregnancies were multiple gestation of which approximately 25% were twins, 4.8% were triplets and 0.2% were quadruplets or more. With blastocyst culture and transfer of one or two blastocysts, the multiple gestation rate is approximately 25% of which 24% are twins and one percent are triplets or more.
Pregnancies with more than one baby represent multiple risks, including an increased risk for pre-term labor and delivery and could result in poor outcome with lifelong consequences for the offspring. These risks increase as the number of fetuses in a pregnancy increases.
Contact Our Fertility Center in the Orlando Florida area
For a review of CRM’s most recent statistics*, as reported by the Society for Assisted Reproductive Technology, please visit the SART website at www.sart.org. To schedule a consultation with our experienced infertility specialists, please contact our office.
* For a number of reasons, the most recent data for all centers are approximately two years old. According to SART, "A comparison of clinic success rates may not be meaningful because patient medical characteristics and treatment approaches may vary from clinic to clinic."
Refers to all attempts at ovulation induction that are intended to lead to an IVF cycle. Cancellation of the cycle before the egg retrieval is attempted may occur if the stimulation is suboptimal. Some programs may not allow older women or men with a severe sperm abnormality to attempt an IVF cycle because these patients are more likely to have cycles canceled due to failure of ovulation induction and fertilization, respectively. Because our infertility treatment centers have a very high IVF pregnancy rate with ICSI, we accept men with severe sperm abnormalities, and we have been very successful even when sperm counts are under 100,000 with poor motility, as well as in cases of a failed vasectomy reversal.
IVF Egg Retrieval
Refers to the actual attempt to obtain the oocytes/eggs from the ovarian follicles. In order to develop a viable embryo, an egg retrieval procedure must be performed and fertilization with the sperm must occur in the embryology laboratory.
A Clinical Pregnancy
Refers to the identification of a pregnancy sac in the uterus. Unfortunately, there are times when a miscarriage may still subsequently occur. It is, therefore, important for patients to consider the live birth rate when evaluating a center's statistics.
Live Birth Rate
Per Transfer is known as the birth of one or more live infants as a result of an embryo transfer. This statistic can provide some insight into the probability of having a baby once a retrieval is performed.
Clinical Pregnancy Rate
Per Embryo Transfer is the statistic that reports the number of pregnancy sacs that appear in the uterus and comparing it with the number of embryos that were transferred into the uterus. The clinical pregnancy rate per embryo transfer may be a less significant statistic since it does not take into account the likelihood of miscarriage. In addition, cancelled cycles before retrieval or due to failure of fertilization are not factored into this statistic. The clinical pregnancy rate per embryo transfer can provide insight into the quality of a program, physician proficiency and is frequently used in the medical literature.
IVF Cycles utilizing oocytes from anonymous or known donors. *NOTE: A comparison of clinic success rates may not be meaningful because patient medical characteristics and treatment approaches may vary from clinic to clinic.