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IVF Success Rates May be Misleading
Some fertility clinics are manipulating their reported IVF success rates, according to a study recently published in the journal Fertility & Sterility. Dr. Vitaly Kushnir, a reproductive endocrinologist with the Center for Human Reproduction in New York City, analyzed fertility clinic data from 2005 to 2010 which was reported to the Centers for Disease Control and Prevention (CDC) as mandated by law, and reported to the Society for Assisted Reproductive Technology (SART) voluntarily.
The study looked at excluded cycles, which are IVF cycles where no embryos are transferred. In this case, the clinics are freezing all embryos of poor prognosis patients. Because there is no transfer, there is no outcome and the cycles do not get reported.
According to the study, excluded cycles “increased significantly from 3.3% to 7.4% between 2005 and 2010. By 2010, 3.8% of centers accounted for 50% of excluded cycles, representing an average of 37.3% of their cycles. These 13 clinics reported significantly better pregnancy and cancellations rates than national averages and collectively increased by 19.9% their share of U.S. ART cycles.”
This is an attempt to manipulate the data, which ultimately misleads the public, Kushnir says.
The study notes that SART allows cycles to be excluded from reporting if the clinic designates them as experimental or if there will be no immediate outcomes, which includes fertility preservation and embryo banking.
Kushner, who works part-time as a consultant with the CDC to improve the system, believes that the current reporting of fertility clinic success rates does not lead to better outcomes. “It actually drives clinics to provide sub-optimal care. There is motivation to report best outcomes.” He believes that reporting needs to be modified, including to track embryo banking cycles and excluded cycles.
Many patients use fertility clinic success rates to compare and ultimately choose an IVF program. Kushnir cautions against this saying, “The data should be used to educate about treatment and IVF but patients should refrain from using it to compare clinics to one another. Use it for general knowledge, not comparison shopping.”