IRMS Infertility Clinic Success Rates  2000 Report

Comparing Infertility Programs

Couples should consider many factors when choosing an infertility program; however, many rely only on outcome statistics related to assisted reproductive technology (ART). Although the number of babies born as a result of ART can be an important indicator of program quality and proficiency, this number is affected by many variables and, therefore, is not an accurate predictor of a couple’s chance for having a baby.

These statistics also do not capture pregnancies that result from other, "low-tech" procedures and many patients at IRMS conceive after surgery, ovulation induction and/or insemination. The ability to achieve pregnancy with ART, or any infertility treatment depends on many clinical and other factors, including but not limited to:

  • The woman’s age
  • Her FSH (Follicle Stimulating Hormone) level
  • The couple’s history of prior treatment, including ART
  • The reason for the couple’s infertility

When using ART statistics to compare infertility programs, remember that pregnancy rates are affected by patient mix, guidelines for patient acceptance or rejection and cycle cancellation policies, among other things. Programs accepting women over age 41 or those with a history of multiple prior ART failures may experience lower pregnancy rates. However, our high level of clinical quality and scientific expertise has allowed IRMS to achieve some of the highest success rates in the world while treating some of the most difficult infertility cases.

Consider your age, the cause of your infertility and other personal factors as you review ART program statistics. Also remember that your chance for individual success is best determined by an experienced reproductive specialist, following a thorough medical history and physical examination.

 

Reviewing the Statistics

IRMS is a member of the American Society for Reproductive Technology (SART) and the American Society for Reproductive Medicine.  ART cycle statistics are reported annually for publication by SART and the federal Centers for Disease Control and Prevention (CDC). Visit CDC's web site for the complete 2000 report.

SART uses a standard reporting format to ensure data consistency. However, outcomes can be measured in different ways, which can affect the statistics programs report to prospective patients. These statistical subtleties are important when reviewing and comparing ART "success rates." They result from the fact that data is collected at different stages of an infertility cycle. Because cycles fail at various points for different reasons, successes reported at one stage may not be carried over to the next. For example, not all initiated infertility cycles result in egg retrieval and fewer result in embryo transfer. Of the total cycles initiated, only a percentage result in pregnancy, and even fewer in a live birth. The percentage of live births reported by a program will differ when it is calculated against all cycles started, instead of the number of egg retrievals or embryo transfers. As a result, the percentage of live births per cycle is lower than live births per retrieval due to cycle cancellations.

When reviewing the statistics as an indicator of infertility program quality, it also is important to consider the number of cancelled cycles – those that start and fail or are abandoned for some other reason during the process. Also pay attention to the average number of embryos transferred and the multiple birth rate. Our experience shows that more embryos do not increase the chance for a pregnancy but they do increase the risk of multiple births.

 

Understanding the Terms

ART Cycles: ART cycles reported to SART can include IVF, ICSI, GIFT and ZIFT; however, IRMS performs only IVF. These cycles include those using:

  • Fresh embryos from non-donor eggs: Embryos are created when the woman’s eggs are retrieved and fertilized in our laboratory. Fresh embryos are returned to her uterus during the same IVF cycle.
  • Fresh embryos from egg donation: Eggs are retrieved from an egg donor when a woman cannot produce her own or the quality is poor. The embryos created from the donor egg and sperm from the partner or donor, are transferred into the uterus of the recipient female.
  • Frozen embryos from egg donor or non-donor eggs: When more embryos are created than are transferred back during a fresh or donor IVF cycle, the extras can be cryopreserved (embryo freezing) for future embryo transfer.

Age Categories: Age is often the single most important factor affecting a woman’s chances for success with IVF. The probability of having a baby diminishes after age 35 and falls dramatically after age 41. In addition, miscarriage rates increase with age. Although positive results are possible for women over 41, the chance of success is substantially decreased without the use of donor eggs. In consideration of age-related variations of infertility, statistics are reported in the following age categories:

  • 35 and younger
  • 35-to-37
  • 38-to-40
  • Over 40

Live Births Per Retrieval: The number or percentage of live births resulting from the total number of successful egg retrievals. This percentage is higher than the percentage of live births resulting from initiated cycles because of cycle cancellations.

Cancellations: Cycles are cancelled for many reasons, including the patient’s desire to discontinue treatment or treatment failure. These cancellations affect outcome statistics and, therefore, they must be reported to ensure an accurate picture.

Multiple Births: IVF uses hormones to stimulate the production of multiple, healthy eggs for retrieval and fertilization. As a result, multiple births (twins, triplets and higher order pregnancies) are more common in ART infertility patients than in couples who conceive without treatment. Multiple birth rates are related to the number of embryos transferred, as well as to the clinical factors affecting a woman’s ability to achieve and sustain multiple pregnancies. Also, some couples choose multi-fetal pregnancy reduction to reduce the total number of fetuses being carried, improving the clinical outcome for both the mother and babies.

Average Number of Embryos Transferred: Quality embryos result in greater success with IVF. Our scientific research and clinical practice focus on ways to improve clinical quality and maintain high outcomes while routinely transferring fewer embryos than many other programs. On average, our patients under age 38 currently receive two or three embryos during an embryo transfer. More are transferred as indicated by specific clinical infertility factors, or in older patients to compensate for the age-related decline in fertility.

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