panorama photo crop

Comparing clinic IVF success rates

Statistics….in fertility, everyone seems to love to talk about statistics.  And when it comes to IVF and donor egg IVF treatments, often it is one of the factors most relied on when selecting a doctor or clinic.  And for a good reason.    You want to give yourself the best chance of success.

Recently I’ve been pondering how difficult it is for a patient to make the statistics meaningful to them.    In the US, it’s easy to look at the CDC or SART charts and pick the clinic with the best stats for your age group and type of treatment.  Well, maybe not always easy to find, but the data is there for you to compare it.  When going abroad, it is a bit more challenging, because there is no equivalent international governing body that is tabulating statistics across all countries and clinics.

But, I think there are some interesting nuances to even the CDC and SART statistics that should be factored into the decision making process – especially when comparing to a foreign clinic that may be reporting data in a different way.    Interestingly, some US clinics elect not to report to SART, because they feel that other clinics can manipulate the data based on how it is reported.

Here is my list of additional things to consider when comparing success rates between clinics.

1). Most success rates are reported by clinic, not by doctor.   You may want to ask about your specific doctor’s success rates.   One bad doctor can bring a clinic’s overall statistics down.

2) The CDC and SART statistics are based on live births – and while that is nice, it means that the data is pretty darn old by the time it is available.  After all, a lot can change in two to three years in the fertility industry and at a clinic.  So really, how meaningful is the data from 2009 when you’re doing a cycle in 2012?   I guess it is a good starting point for narrowing down the clinics to talk to – but ONLY a starting point.  I recommend contacting each clinic individually to find out their most recent statistics.

3) If you really want the most recent data, you may be better served by asking for the clinical pregnancy rates (pregnancies where a heartbeat is detected).  Statistically, a large majority of pregnancies where a heartbeat is detected continue on to a live birth.   There is very little a RE doctor has influence over that would change the outcome of your pregnancy after a heartbeat is confirmed.  So, comparing clinical pregnancy rates is a reasonable and far more current way to measure how a clinic is doing statistically.

4) Some clinics push their patients to do some sort of genetic screening or testing on the embryos (PGD, PGS, CGH) prior to selecting the embryo for transfer.  While that can provide very valuable data and may help them choose the most competent embryos,  it comes at significant cost.  So, if you don’t plan on doing genetic screening or testing on the embryos prior to transfer, ask for the success rates of patients who did NOT have this testing and use that for your comparison.

5) Some clinics transfer a higher number of embryos in an effort to increase the chances that one will stick.  This is an important factor to consider when selecting a clinic.   On average, how many embryos do they normally transfer to a patient in your age bracket with your type of treatment?

If you only plan to transfer one embryo (to reduce the chances of multiples), then ask to compare their elective single embryo transfer (eSET) rates for your treatment and age range.  Many of the top clinics are reporting great eSET pregnancy rates with only a slight increase in pregnancy rates when transferring two embryos.   Be sure that you know your clinic’s eSET pregnancy rate as well as the percentage of pregnancies where more than one embryo is transferred resulting in twins, triplets or more.

You will always want to talk to the doctor and embryologist prior to transfer to decide what is best for your case, but it is helpful to know before your cycle what the clinic’s statistics are in these situations so that you can really think this through in advance.  The last thing you want is to be sitting in your doctor’s office the day of transfer – hormones raging – feeling pressure to transfer more embryos than you are willing to carry.

With the technology for freezing and thawing embryos improving dramatically, especially in donor egg cycles, we are seeing a move by many top clinics to recommend eSET, because a singleton pregnancy is statistically less risky for both the mom and the baby.

6) Ask the clinic how they report results of cycles where the outcome is unknown.   Many foreign clinics are required to report a cycle as “failed” if they are unable to get a pregnancy confirmation from the patient..  This  may bring down their overall success rates.   This is far more of an issue for patients going abroad for IVF treatment, because it is difficult, if not impossible for the clinic to verify the results once the patient returns to their home country if the patients do not voluntarily contact them with the results.

7) Ask the clinic what percentage of women in your age group, with your diagnosis and desired treatment are accepted into their program.   Some clinics have been accused of having very narrow acceptance criteria in an effort to keep their overall statistics high – in essence cherry picking only the patients who are most likely to add to their success statistics.  On the other hand, you don’t want a clinic that is not honest with a patient about their likelihood of success.  Optimally, as long as it is medically safe, you want the doctor to inform a patient of the likely success statistics based on their case and let the patient decide if they want to pursue treatment.

As a person that loves statistics and can spend hours reviewing them, I think it is important to dig beyond the surface statistics reported by the CDC, SART and clinics themselves and weigh in these other factors when deciding what clinic is the best for your treatment.

This entry was posted in Donor Egg IVF, IVF Treatment Abroad and tagged , , , , , , , , , , , , , . Bookmark the permalink.

Comments are closed.