INTERPRETING SUCCESS RATES

When we discuss a fertility center's success rates, we are generally referring to their success with in-vitro fertilization (IVF). IVF Success Rates for every center should be interpreted with extreme care. Comparisons between centers are difficult. There are many factors that contribute to a center's success rates that are outside of the control of the center. On the other hand, there are some factors that the center may control through practice patterns that may alter IVF success rates.

Examples of factors that are out of the center's control include patient characteristics. Some centers predominately see patients that have failed treatment elsewhere, some have polycystic ovarian syndrome (PCOS), and some have advanced reproductive age, or poor ovarian reserve not accompanied by advanced reproductive age. All of these affect the potential for IVF success.

A center that pushes patients to IVF rather than encouraging them to consider all their therapeutic options and allowing them to pursue other options before considering IVF, is selecting the patients that are most likely to achieve success with IVF and thus bolster their success rates. Centers that encourage choice in therapeutic options often attract the most difficult to treat patients in their IVF programs, and consequently may have lower success rates.

ACIRM takes the approach that the patient deserves to be given an understanding of all their therapeutic options, and once fully informed, be extremely involved in their therapeutic decisions. ACIRM does not treat infertility with success rates in mind (we do NOT make therapeutic recommendations designed to bolster our IVF success rates). But if IVF does become necessary, we perform such with a commitment to patient safety, and to achieving the greatest success for the individual patient.

With larger programs that perform over 800 IVF cycles per year, the success rates are likely to be meaningful within that year. The care that one may receive in such a large program is likely to be less individualized and less emotionally supportive than at a more intimate center like ACIRM.

In smaller centers like ACIRM, the success rates may vary from year to year, due to variability in patient characteristics that are out of our control; however, the success of the donor egg program in a small center should reflect the capabilities of the center since most patient variables have been eliminated in this population.

Our donor egg program's success rate has been top notch for several years, averaging 71% live birth rate per donor IVF cycle for the years 2001 through 2009, significantly above the national donor egg IVF cycle average of 54%.

We show our success rates below as they have been reported to the Center for Disease Control (CDC) for the years 2007 and 2008, and our preliminary data for 2009 (preliminary because ongoing and delivered pregnancies are shown rather than live births alone). Success rates are reported the year following the data collection (to allow for complete outcomes; birth typically happens 7 to 9 months after the IVF cycle begins) and success rates are published by the CDC a year after the data are reported (which is essentially two years after the data is collected).

Understanding the Treatment Data

What is a fresh in-vitro fertilization (IVF) cycle?

A fresh IVF cycle involves using medication to stimulate a woman's ovaries to produce eggs, followed by a surgical procedure called an oocyte (egg) retrieval in which a needle is placed under ultrasound guidance into the woman's ovaries to get all of the eggs that were produced from the stimulation. In the embryology laboratory, each egg is exposed to sperm or injected with a single sperm in a process called intracytoplasmic sperm injection (ICSI). The eggs are then incubated in the embryology laboratory for the next three to five days while they undergo the natural process of fertilization and developmental division. After the incubation period, a number of resulting embryos are chosen for transfer to the uterus of the woman (non-donor IVF) or of another woman in the case of donor egg IVF. The remaining embryos are frozen for storage and possible use if the process fails, or if it succeeds and more children are desired. Donor egg IVF is generally used for women that are unable to produce eggs or whose egg quality is found to be extremely poor.

What is a frozen embryo transfer (FET) cycle?

An FET cycle is what occurs when a woman's uterus is prepared for transfer of embryos that were obtained during a prior fresh IVF cycle and frozen during that process. After the uterus is appropriately prepared, usually with hormonal therapy, a certain number of stored frozen embryos are thawed and transferred to her uterus. This type of therapy hopefully results in pregnancy without having to conduct a fresh IVF cycle, which are more costly and physically and emotionally taxing to the patient.

What is the risk for high order multiple pregnancy (triplets or more)?

Many couples are concerned about the possibility of incurring a high order multiple pregnancy (triplets or more) and believe based on news events that fertility therapy has a high risk for this occurrence. These occurrences are actually rare and hence why they are so newsworthy. In fact, of all fertility therapies, IVF therapy has amongst the lowest risk of high order multiple pregnancy, when undertaken in the proper environment and with an appropriately trained physician. This is because we have control over the number of embryos that are transferred to the woman's uterus.

The success rates listed below for our center were achieved with uterine transfer of generally no more than 2 embryos in women less than 38 years of age (whether in fresh or frozen cycles from non-donor embryos) and with transfer of no more than 3 embryos in women aged 38 years and older (most still receiving only two embryos). Uterine transfer of no more than two embryos occurred with all cycles (fresh and frozen) in which embryos from donor eggs were used. Some patients opt to only transfer a single embryo (elective SET).

Data submitted to CDC (2009 Data In Progress)

IVF - Fresh Embryos from Non-donor Eggs

FET - Frozen Embryos from Non-donor Eggs

Donor Eggs - Fresh Embryos

Donor Eggs - Frozen Embryos

*2009 data represent ongoing pregnancy or live births