A fertility clinic’s IVF success rates are an important, public indicator of that practice’s results in a major area of infertility treatment. Servy Massey Fertility Institute (SMFI) recognizes that patients and prospective patients can often base a significant portion of their evaluation of a practice and its physicians on their in vitro fertilization (IVF) success rates.
We have been performing IVF for quite some time, pioneering aspects of this now frequently used assisted reproductive technology.
But there is more to IVF success rates than meets the eye. These rates are not as clear cut as, say, a batting average that clearly shows the percentage of hits a baseball player gets per at-bats.
IVF success rates come with nuance related to the types of patients receiving the treatment. We have better odds of IVF success with some patients than with others. For example, age, surgical history such as endometriosis or ovarian cyst removal, and medical history are key factors that can influence a person’s likelihood of success with IVF. There are new measures of ovarian reserve, which are not always related to age. The anti-Müllerian hormone (AMH) level is key; the antral follicle count of the ovaries on ultrasound is another.
Our philosophy is to help as many patients as we can to become parents. We will do everything we can to help them attain pregnancy, even if their chances of success with IVF are not particularly good. We believe every person deserves a chance to make that choice. Of course, there are situations when IVF is medically or emotionally unadvisable, and we make those calls with the individual on a case-by-case basis. However, we do not turn down patients with poor prognosis. If the prognosis is low, we give information and let the patient decide.
Success can often relate to obesity. The skill of the clinic in performing IVF is primarily based on the lab.
Factors that can decrease a patient’s chances for IVF pregnancy success
- Woman’s age. Egg quality and quantity decline with a woman’s age. Women at higher ages also experience more miscarriages, due to the increase with age of chromosomal abnormalities in the eggs. Though these possibilities affect women in different degrees, they are major factors in IVF success.
- Choosing elective single embryo transplants (eSET). This increases the chances of IVF failure but also increases the chance of not having a multiple pregnancy of twins or more. A single, healthy baby is the goal, even though performing more IVF cycles with eSET may reduce our clinic’s overall IVF success rates.
- Having failed with IVF previously.
- When both partners in a couple have infertility issues.
- Recurrent miscarriage, which is when a woman has had one or more miscarriages consecutively.
- Presence of other conditions in the woman, such as uterine abnormalities (fibroids or malformation), types of ovarian dysfunction and hydrosalpinx, which is fluid in the fallopian tubes. These conditions may need surgical correction prior to IVF.
SART’s publication of IVF success rates
The Society for Assisted Reproductive Technology (SART) is the gold standard bearer of IVF success rates. SART’s goals are to ensure that its member clinics follow strict guidelines in preforming IVF and other technologies, in reporting IVF data accurately, and in reporting it ethically. We are members of SART, as are many other IVF clinics (in fact, we advise that people not use a clinic unless it is a SART member). About 95 percent of all IVF cycles in the United States are reported to SART.
The Centers for Disease Control and Prevention also publishes data on assisted reproductive technologies. This is another source of data patients may want to review. Our clinic, and many others, believes that data from SART can help patients get the clearest idea of their chances of IVF success at a particular practice. SART makes sure member clinics report their IVF data accurately, without applying a marketing spin to it and without cherry picking which data to report.
The Society has refined its reporting methods so clinics cannot hide failed IVF cycles. SART has refined its data to reflect changes in IVF procedure, such as an increased use of genetic testing, eSET and implanting frozen embryos. It reports the number of cycles and the number of births of healthy babies. By tracking an individual’s outcomes over time and accounting for differences in fresh and frozen embryo transfers, SART data offers the best way for a patient to gauge the expected outcome of IVF.
Caution on using SART data for an absolute answer
While it is very useful to have SART data to reference, there are some things patients should keep in mind when using that data as a yardstick to measure different clinics.
Patients shouldn’t use SART data as the sole indicator of a clinic’s quality of care or of a patient’s true chance of IVF success. SART’s disclaimer on why they don’t provide information on patient characteristics reveals the reason behind this caution:
“For this reason, the clinic summary reports are best used as a foundation to discuss the chance of success with your physician. Your SART member physician is in the best position to assess the diagnosed infertility factors and estimate your success in the context of your particular factors and the prior experience of the clinic. Despite the limitations of the current clinic summary reports, it is our goal to collect and analyze information that might better help predict an individual patient’s chance of success within a clinic.”
An example people may be able to relate to is taking the SAT when applying to college.Students’ scores on the SAT are not the only predictor of how well they would do in college. That is why colleges also require an essay, a student’s extracurricular activities, etc. The SAT is just one aspect to the college application.
SART acknowledges what we pointed out above about including good and bad prospect patients in IVF treatment. They state that some physicians and practices, with good intentions, may discourage or deny patients who are predicted to have a low chance of success from pursing IVF. But other practices, also with good intentions, may do the opposite and encourage them to pursue IVF.
For example, sometimes the best course of treatment is for a patient to go right to IVF. Sometimes it is best to try ovulation stimulation and intrauterine insemination (IUI) first to help a patient achieve pregnancy on her own. Centers that send everyone to IVF immediately will have better outcomes. We consider IUI to be highly cost effective for many couples.
SART does offer an online patient predictor of IVF success based on nationally obtained data from more than 2 million cycles. They also caution that this predictor does not take into account the differences in IVF program quality found in clinics.
We encourage patients who desire more information about our clinic beyond SART’s published IVF success rates to contact us. We can discuss SMFI’s approach to treatment and how we determine what path might be best for a patient.
The best thing to keep in mind is that IVF success rates are important, but not the end of the story. Patients should have a broader vision of what makes a clinic a good fit for them. Asking us questions is the best way to find out.