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Honesty in IVF Reporting
August 27, 2013
Although the CDC advises fertility patients against using IVF success rates to compare fertility clinics, most patients consider success rates as an indicator of skill in the embryo lab and thereby make important decisions about where to receive their fertility care. In 1992, the Fertility Clinic Success Rate Reporting Act provided a means for the CDC to monitor clinics, though lack of manpower prevented them from conducting site visits of more than 10% of the clinics across the country. By 2002, it was evident this method of reporting was unsuccessful and it has since been left up to the individual fertility clinics to honestly report their IVF successes annually to the CDC.
Why is it so important for fertility clinics to show honesty in IVF reporting?
The answer is simple. Each clinic abides by its own rules and general guidelines set forth by the American Society for Reproductive Medicine (ASRM) for cancelled cycles, number of embryos transferred, which patients are rolled into the research group (thus allowing the outcome of their cycle to go without reporting), and age or diagnosis cut-offs for IVF patients. Although the CDC report displays success rates on the same plane, the data itself may not be uniform. Not to mention, clinics are only reporting live births after IVF, not success after reproductive surgery, IUI, or other conservative treatments.
William Ziegler, DO, of the Reproductive Science Center of New Jersey believes a more accurate representation of a fertility clinic’s success would be to report all fertility treatments. Currently, there is no available data on patients who get pregnant after reproductive surgery or more conservative fertility treatment. “If we push every patient to IVF, it could drive the success rates really high which inflates and falsifies data being reported to the CDC,” Ziegler explains.
Once the IVF success rate data is reported to the CDC, it is available for the public to see. The public does not understand how these numbers can be altered by a clinic to inflate their success rates. One needs to understand that this information is not an accurate representation of a clinic’s success.
Dr. Ziegler proposes a more uniform way to present data would be for clinics to report the following categories:
- Number of live births/embryos transferred
- Live births/Clomid with IUI cycle starts
- Live births/follicle stimulating hormone (FSH) fertility drug injection with IUI cycle starts
- Reproductive surgery cycle starts
- Natural conception after reproductive surgery
- Number of IVF research cycles
“We need a better way of reporting our success rates showing all categories of treatment to accurately portray the fertility clinic’s success in all areas if this is the tool patients are going to use to select their fertility doctor for care, “he says.
When analyzing fertility clinic success rates, patients will notice most clinics across the country fall in line with the national average. However, there are some clinics “out in left field” as Dr. Ziegler describes. These extraordinarily high success rates should raise a red flag for the average consumer. Clinics can manipulate their rates by excluding cycles, pushing patient’s to IVF, and not offering other treatment options.
Given the serious nature of fertility treatment, patients should interview several doctors to find the best fit. After all, there are more criteria than just success rates! Does the clinic you’re considering lack the warm and fuzzy feeling you’re looking? Do you have a preference for seeing one doctor throughout the course of your treatment or a larger treatment team? Only you can decide which factors are most important to you. Take these points into consideration as well as success rates for finding your perfect fertility doctor match.