As the world of fertility therapy continues to advance in terms of technology and successful pregnancy outcomes, more and more patients are seeking out these services based on data published online by fertility centers within their geographic regions. Specifically, what patients most often seek out are the “success rates” for those centers’ in vitro fertilization, or IVF, programs. Being that the current success rates of IVF are at the highest levels they have ever been, the apparent differences in these rates between programs throughout the state in reality may have been manipulated by certain centers to appear larger than they actually are. In addition, given the diversity in patient populations among different fertility centers, the Society for Assisted Reproductive Technology (SART), a governing body of the American Society for Reproductive Medicine (ASRM) has specifically prohibited comparison of success rates with other specific clinics, including implied comparisons. As stated in a recent letter from the SART advertising chair and the SART president, “you can say you are an excellent program but cannot state that you are the best”. Such SART guidelines are intended to assure presentation of accurate and clear information to patients and physicians alike.
Recently, an area of concern has emerged in terms of advertising of IVF success rates. As pointed out in another recent letter from SART president Dr. David Ball, the 1992 Fertility Clinic Success Rate and Certification Act requires that all IVF cycles be reported. They interpret this to mean that all started IVF cycles should be accounted for in clinics’ outcome reports, and to do otherwise leads to the inability of patients to evaluate outcomes on a level playing field and determine their true probability of success. What this means is that patients who undergo an egg retrieval where no embryo transfer is performed are designated as “banking cycles,” and are excluded from that center’s published IVF success rates. The problem is that this practice clouds the data with regards to outcomes, making it impossible to accurately interpret.
Patients who are likely to have a poor chance for success are eliminated from that center’s fresh IVF success rates, thus artificially raising these rates and therefore misleading the public. In certain circumstances, embryo banking is absolutely indicated such as when preimplantation genetic diagnosis (PGD) is performed and the results are not available quickly enough for a fresh embryo transfer to occur, however arbitrary banking of embryos in patients who may not have a high chance for success so as to protect a clinic’s success rates goes against the grain of what the society’s intentions truly are.
Here at our Center, we have always followed the SART guidelines in terms of open and accurate presentation of our success rates. We are proud of the tremendous rates we have achieved, including in the categories of egg donation and frozen embryo transfers, and continue to maintain excellence in all of our programs. Such dedication is what motivates us to help all of our patients in their ongoing quest to conquer infertility.