CRM : Center For Reproductive Medicine

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.

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.

Centers seeking the highest pregnancy rates regardless of the consequences also have a tendency to transfer a larger number of embryos and, accordingly, accept higher order multiple pregnancies. To an infertile couple this may seem acceptable; however, multiple pregnancies result in a higher risk of both maternal and fetal complications. Multiple births born to women at any age are high-risk births with twins being 4 times, triplets 10 times and quadruplets 13 times more likely than singletons to die within the first month of life.

Our Standards

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.

And our success rates remain high. CRM truly is a place “Where dreams are conceived” with the most ethical and compassionate approach.

Definitions

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 Practice

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."

Over the years, the Center for Reproductive Medicine has helped hundreds of couples make their dreams of parenthood a reality. Our physicians and staff work tirelessly to give our patients the best chance to conceive. Our lab has been the setting for countless in vitro fertilization (IVF) success stories since we opened our doors in Orlando, Florida in 1985, and today we continue to offer an array of testing and treatment options for infertility as well as counseling and support to help aspiring parents through trying times.

Ashley and Tyler

I was 37 years old and just considering the thought of motherhood. We tried unsuccessfully for over a year before realizing we needed to seek help from a fertility specialist. I was already 38 and time was running out.

I had heard wonderful things about Dr. Gary DeVane of the Center for Reproductive Medicine, and met with him in the fall of 2005. As nervous and apprehensive as I was, I felt totally at ease with Dr. DeVane. After routine testing, he found that I had a few issues to consider. I had a thyroid disorder, imbalanced hormones, and abnormal levels of cholesterol and triglycerides, as well as a genetic clotting defect called MTHFR. Though these problems were treatable, I would need heparin shots and extra folic acid in order to maintain a healthy pregnancy. Through the Center for Reproductive Medicine's excellent mentor program, I connected with a wonderful mentor who had been through the program and frequently sent me encouraging emails and words of advice.

I had my first artificial insemination in January of 2006. It was simple and convenient. Almost two weeks later, I took a pregnancy test. It looked like a plus sign! I called the Center for Reproductive Medicine and they told me to come in that day. After testing, they said I was pregnant, but that we would have to re-test in a couple of days to make sure it was a viable pregnancy. I was stunned, and ecstatic that it could have worked so quickly. I immediately started the heparin shots and folic acid, and we were on our way.

Kelsey Lee Kurau was born on September 19th, 2006. I had an easy delivery with no complications. Now Kelsey is nine months old, and we are trying for another baby. I am almost 40 and back at the Center for Reproductive Medicine thanks to our wonderful experience there with our first child.

After all of this, I have realized that sometimes the most challenging things in life are the things that give us the greatest joy. I love my child immensely, and I think I have an even stronger bond with her thanks to everything I went through to have her. I hope that my story gives others hope and encourages other women that their dreams, too, can come true.

King and Datasha

In January of 2006, my husband and I were waiting for the news we have been waiting to hear for about eight years. Two days prior, his office called us and told us that we were pregnant. We were just waiting for confirmation, but it never came. Instead we received the worst news imaginable from our first IVF doctor: I was nine weeks pregnant and there was no heartbeat. After this miscarriage (my second), I didn't think it could ever get any worse, but then the IVF doctor told us that the only way we would ever have biological children was through a surrogate mother. We dealt with the devastating news the best we could, and then decided to focus on my health. That led us to Dr. Gary DeVane of the Center for Reproductive Medicine.

Unlike our previous doctor, Dr. DeVane thought I could have my own children, and he took the extra steps to try to identify the cause of my recurrent miscarriages so it could be treated. He quickly ruled out some of the more common reasons for my miscarriages and ordered comprehensive blood work. I was diagnosed with polycystic ovary syndrome (PCOS) and a blood-clotting condition called antiphosphilipid syndrome (APS). I also had a slight folic acid deficiency.

We did not rush into IVF again; Dr. DeVane suggested some lifestyles changes first and put me on medication to assist with my PCOS. After about a year, we took the IVF dive with Dr. DeVane because it was the best possible way for us to conceive. Because of my PCOS, the staff at the Center for Reproductive Medicine carefully prescribed fertility medications to ensure I had the proper dose (it was challenging).

On the second try, success! We had 12 beautiful eggs that were removed. Seven were fertilized, and three made it to day blastocyst. Of the three, two looked very promising and Dr. Randall Loy transplanted them. One of those two is now our little baby boy who is due May 4, 2008. Because we put our faith in God, who directed us to the excellent staff of the Center for Reproductive Medicine, we are now able to experience our son growing inside me and soon we will be able to hold him in our arms.

Contact the Center for Reproductive Medicine Today

If it is your dream to raise a child and you have been struggling with infertility, contact the Center for Reproductive Medicine. With all the advanced resources and expertise needed to help you conceive, we offer an excellent chance of success even to many patients who haven’t had success with other fertility practices. Visit us today to learn more.