Infertility and Assisted Reproduction

A.R.T: Clinic Statistics and Success Rates

Success rates for assisted reproductive technologies (ART) vary greatly, as many factors affect them, including the kind of procedure performed, the health and age of the individuals involved, and the skill and experience of the clinic. The Centers for Disease Control and Prevention (cdc.gov/art) and the Society for Assisted Reproductive Technology (sart.com) gather and publish yearly statistics on the success rates of various procedures. Though all IVF clinics are required by law to report their data to the CDC each year and about 85 to 90 percent do so, the only penalty for clinics that don’t is that the CDC publishes their names as “nonreporters.”

The CDC warns against using just the report to rank clinics, because despite the standard format, differences in success rates are tricky to interpret. Still, the numbers give you a place to start and contain some important information that can help you evaluate fertility clinics. It is important to ask several questions as you view infertility statistics:

How is “success” defined? Success can be defined many different ways—by the number of embryo transfers, the number of pregnancies, or of births. What you are interested in is the live birth rate (preferably single births) among women of your age and diagnosis using the same treatment you are undergoing.

Are there parameters excluding certain women from the clinic? Some clinics may refuse to take on particular women, such as women above a certain age or women who are unlikely to conceive, in the hope of bumping up their statistics. Pay careful attention to the ages, diagnoses, and other characteristics of the patients the clinic routinely treats. Select one that has had good success with patients like you.

What is the average number of embryos transferred per IVF cycle? What is the singleton live-birth rate? Responsible ART programs try to maximize their pregnancy rates while minimizing the multiple-pregnancy rate. Needing to transfer too many embryos may indicate suboptimal laboratory conditions or a less refined embryo transfer technique.

Does the clinic offer elective singleembryo transfer (e-SET)? What is its live-birth rates after e‑SET?

What are the frozen embryo pregnancy and birth rates? In order to maximize the number of pregnancies that can be achieved from a single egg retrieval (and lessen your need to take additional fertility medications), it’s important to assess your clinic’s experience with frozen embryos. Increased pregnancy rates from frozen embryo transfers are also an indirect indication of a high-quality laboratory and transfer procedures.

Numbers count! If a clinic performs only a few ART cycles every year, all of its measures of success will be statistically imprecise, and a high (or low) success rate may be that way because of chance rather than skill. Choose a clinic that has a high success rate based on large numbers of cycles.

For more information about IVF clinic statistics, see the CDC’s video “Infertility: A Tutorial on the ART Report” (www.cdc.gov/art/PreparingForART.htm) or read its fact sheet at www.cdc.gov/art/PreparingForART/Tutorial.htm.

Excerpted from the 2011 edition of Our Bodies, Ourselves. © 2011, Boston Women's Health Book Collective.