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IRH Success Rates

The Institute for Reproductive Health has helped thousands of couples to succeed in achieving their dream of parenting over the years. Many factors affect success rates. The two major factors are the severity of the disease process and the quality of the treatment.

Some treatments offer modest results. These include Clomid and insemination with conception rates of 10-15% per cycle. Injectable medications such as Gonal F or Follistim coupled with insemination offer superior treatment. In Vitro Fertilization offers the highest conception rates.

Individual success rates for IVF vary depending on age of the egg and severity of the disease process. A 32 year old woman would be expected to have a higher conception rate than and 42 year old individual. Conception using a donated egg for the 42 year old individual would give her the same conception rate as the 32 year old individual.

The Society for Assisted Reproductive Technology (SART) advises against comparing clinics on a purely statistical basis since some clinics may treat more difficult cases and others treat easier cases to improve the appearence of their statistics. One common technique to eliminate difficult cases is to screen based on FSH and reject patients with FSH levels that are poor. IRH does not discriminate against patients based on FSH levels.

IRH reports its IVF data yearly to SART and the CDC. The data is reported most recently from 2013. Remember that a December IVF cycle's outcome may not be known till October and it takes some time for data collection and reporting.

Our most recent IVF data reported nationally is for 2013 and can be found at SART DATA

Making Sense of ART Statistics

What are your odds of getting pregnant from a given procedure such as IVF or a frozen embryo transfer? The question is easy but the answer is complicated. It is useful to know that the data for IVF is nationally reported and compiled annually. The data is reported by better programs to SART or the CDC. The intent of this reporting is to give the public accurate information about what their odds of success are with a given procedure such as IVF in a specific program.

Success rates usually are computed by taking a certain numerator and dividing it by a certain denominator. As an example the numerator could be live birth and the denominator could be egg retrievals. So for example in a given year if 100 egg retrievals were performed and these resulted in 40 live births, we could say that the success rate was 40%.

Unfortunately there are many ways to distort statistics. You could change the numerator or you can change the denominator. Also some programs may do more complex cases and other programs may restrict themselves to easier cases to improve their statistics. It’s also possible to take some cases that are less likely to succeed and transfer those cases to other types of treatment cycles. For example it’s possible to take cases where the embryos are suspected to not be high quality and test and freeze those embryos. In that case there would be no fresh embryo transfer and all the statistics would be shifted to a frozen transfer. For example if 5 egg retrievals are performed and no embryos transfers are completed for those cycles, the cycles could be deleted from the fresh statistics. Also if there are no high quality embryos available from those 5 retrievals you could delete them from the frozen statistics too. This brings up the famous quote from from Mark Twain: “There are lies, damned lies and statistics”. With this disclaimer we would like to define some common terms that are used in reporting IVF statistics.

Initiated cycle is at term for all attempts at ovulation induction with the intent of performing an IVF cycle. If the cycle is not acceptable then cancellation may occur. Retrieval refers to an actual attempt to begin to collect eggs from the follicles. Some cycles may not proceed to retrieval and some retrievals cannot proceeded to transfer. Embryo transfer refers to a cycle in which embryos are available for replacement. There are various kinds of pregnancies. A biochemical pregnancy is one in which the pregnancy test is positive but may have not reached a point where we can see the pregnancy on ultrasound. A clinical pregnancy is a pregnancy they can be seen on ultrasound. A miscarriage is a pregnancy that was seen on ultrasound but subsequently has been lost from the uterus. A live birth is naturally the most desired outcome

It is common when looking at IVF data to look at live birth rates per retrieval. This is the chance at the program of having a live born baby if egg retrieval occurs. Also, another looked at statistic is live birth for stimulation. This is the chance of actually having a live born baby should you begin a stimulation. Live birth rates per stimulation will be lower than per retrieval because some stimulations may be canceled to not proceed to retrieval.

Another, statistic is clinical pregnancy per retrieval. This is the chance of having a pregnancy they can be seen on ultrasound following egg retrieval. Some of these pregnancies will not result in live birth.

In addition to raw statistics about success rate per retrieval, it’s important to look at the number of cycles the clinic performs. A clinic performing a high number of cycles is more likely to have specific expertise in IVF. Also it’s unlikely that the clinic in selecting high number of easy cycles to perform. It’s also important to look at the multiple pregnancy rates. A better clinic should have good clinical pregnancy rates per retrieval but have multiple pregnancy rates that are as good or less than national average. Particularly the number of pregnancies more than twins should be quite low. Also look at the average number of embryos that are transferred. Better clinics should be transferring one or 2 embryos in many cases.

Another quality statistic is whether clinic offers a money back guarantees. The money back guarantee should be guarantee to live birth. It’s unlikely that a clinic with poor success rates would offer this program. You may want to look at regional clinics in the area and compare some aspects of volume as well as pregnancy statistics. This should give you a general idea of the size and success of the program. Factors commonly known to affect pregnancy rate include age as well as ovarian reserve. Ovarian reserve is best estimated by looking at the AMH level. It’s also important to discuss the chances of success for your particular procedure at a particular program with the staff. Ultimately your chance of live birth will depend on how difficult your case is and the quality of the program.

IVF data are compiled annually and reported at www.sart.org, and
http://www.cdc.gov/art/reports/index.html
 
 
 
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