When exploring fertility centers and treatment options, it’s easy to become overwhelmed with the sheer quantity of information that comes with pursuing next steps to grow a family.
In addition to weighing the expertise of the physician and reputation of the center, another critical factor to assess is clinic success rates. A success rate is the percentage of treatments that result in a positive outcome, such as a pregnancy and/or live birth. This can be expressed as the number of treatments per cycle started, per egg retrieval or per embryo transfer, so it is important to look at both the numerator and what the denominator represents.
While it can appear to be relatively simple and straightforward - the higher the percentage, the better, right? - it is actually a bit more complicated than a simple statistic.
Our goal is to equip you with all the background information you need to become an instant pro at understanding success rates and how to find the numbers most applicable to your situation.
We know success rates are confusing. In fact, the Society for Assisted Reproductive Technology acknowledges this in a statement that pops up before you can view center data:
Accurate and complete reporting of ART success rates is complicated. Clinics may have differences in patient selection, treatment approaches, and cycle reporting practices which may inflate or lower pregnancy rates relative to another clinic. This report is best understood in consult with your physician.
Success rates include specific treatments. Since 1992, fertility clinics across the country are required to collect and make public the results of assisted reproductive technology (ART) treatments including in vitro fertilization (IVF), frozen embryo transfer (FET), and donor egg treatment. This information is collected and published annually, and posted on the Society for Assisted Reproductive Technology (SART) website. If a clinic does not report their outcomes to SART, this is often a red flag.
The data is customizable to individual patient scenarios. How data is compiled and displayed has come a long way, and now you can view national success rates based on your diagnosis and where you are on your treatment journey. The first categories to choose from include: National Summary, Patient’s Own Eggs, Donor Eggs. From there, you can drill down in Patient’s Own Eggs to look at success rates for all transfers, first transfers, frozen transfers and new patients.
Donor Eggs breaks down into fresh donor eggs, frozen donor eggs, thawed embryos and donated embryos. If you’d like, you can also filter success rate results based on cycle type (4 options), diagnosis (10 options) and additional options such as First IVF, PGT, gestational carrier and more.
To help you, SART has put together a five-minute video called Understanding the SART Clinic Report.
You can look closely at the data for each center you’re considering. To view specific success rates for a particular center, click here and enter the center’s zip code and state. You can compare success rates for one clinic versus another as well as the national data summary. When pulling up success rates, take into account your age and if you’ve pursued treatment before and any potential diagnostic information that is applicable. In reviewing the data, it is important to consider the number of cycles a clinic performs. It is difficult to assess the quality of a clinic with few patients in a given category.
Other factors that play a role are whether the clinic “cherry picks” the patients that it will treat as some will exclude patients with a poor chance of success, and is the clinic in an insurance mandated state? When a state mandated insurance benefit is available to the majority of residents, a greater portion of individuals with infertility will seek treatment, even those with a poor prognosis, since the treatment is covered.
In addition, it is helpful to look at the average number of embryos transferred and the multiple pregnancy rate. If a clinic is transferring more embryos to maintain success, this can result in a higher incidence of multiple pregnancy and complications. A good measure of the quality of an embryology lab is the percentage of younger patients (<37yo) who undergo an elective single embryo transfer (eSET) and achieve an ongoing pregnancy.
A general success rate statistic is meaningless. Given the myriad different diagnoses, patient ages and treatment paths, you can see how a general success rate statistic holds little value. If a treatment facility touts a general success rate, consider this a red flag. Reputable centers offer individualized success rates after taking into account a patient’s personal circumstances.
The number of cycles completed matters. As mentioned above, success rates change in context when you also consider the quantity of cycles completed per year, and for how many years. Would you want to place your bets on a horse that had won all of his races, but only competed in a handful of competitions? Quantity matters. Between our River North and Highland Park IVF labs, Fertility Centers of Illinois completed approximately 5,548 cycles in 2017 (the latest data available). None of our IL competitors come close to half (and in some cases, a quarter or even a tenth) of that amount.
Physician teams work together for your success. Our 11-physician team collaborates to ensure all options are considered to maximize your chances of success. We have been around for over 35 years, and in that time, we have gleaned a vast amount of knowledge by treating thousands of patients and conducting extensive medical research. This knowledge also contributes to your success (and our success rates).
A strong point of differentiation: success rates after thawing eggs/embryos. Technology has advanced so that the success rates for a frozen embryo versus a fresh embryo are virtually the same, but this only applies to centers with an experienced embryology team with years of experience. This point of differentiation becomes even more important when considering donor or patient frozen eggs that must be thawed, fertilized, with the remaining embryos frozen.
The more an egg or embryo is frozen and thawed, chances of success lessen. In the hands of an experienced embryology team, these chances are much higher. For those considering freezing eggs with an egg freezing boutique clinic, keep in mind that these facilities have a lot of experience freezing eggs, but may have little experience in thawing them.
To learn more about how an embryology team is involved in your treatment journey, check out Sneak Peek: What Happens In An Embryology Laboratory?
We hope this information is helpful to you as you determine next steps. Don’t hesitate to bring questions on success rates to your physician consultation!
Author Bio: Dr. John J. Rapisarda