The Society for Assisted Reproductive Technology (SART) recently published its 2009 IVF Success Rates, and Shady Grove Fertility is pleased that our Center exceeded the national averages in nearly every category for fresh IVF cycles.
According to SART, Shady Grove Fertility is the largest fertility center in the country based on the number of treatment cycles performed. In 2009, we performed a total of 3,673 fresh IVF cycles, resulting in an average pregnancy rate across all age groups (<35 to >42) of 43% compared to the national average of 37%.
As the leaders in the area of reducing high risk multiple pregnancies (twins and triplets+) through elective Single Embryo Transfer (eSET), we are especially pleased with the high live birth rate we have achieved. This means that more live births occurred even though fewer embryos were transferred per procedure.
We know how important these success rates are to patients undergoing treatment and to those just beginning to explore their options for treatment. We also know that sorting through IVF statistics can be a challenge. Fertility center websites and other online forums present a wide array of statistics in many different formats. For success rates to be a truly useful tool for patients, they must know who the trusted sources of data are, what the different reporting categories mean, and what the data reveals about individual fertility centers. Read more to find out the answers to these questions, and, most importantly, what are your chances of having a baby.
Where Can You Find Trusted Data?
SART and the Centers for Disease Control (CDC) are considered the most trusted sources for IVF statistics, and their websites provide extensive information on assisted reproductive technology. In 1992, Congress passed the Fertility Clinic Success Rate Reporting Act, which requires centers that provide IVF services to report their outcomes annually to the federal government. According to the CDC, nearly all of the 436 fertility centers in the US, both SART and non-SART members, report their yearly data. Centers that do not report their data are listed on the CDC website as “nonreporters,” as required by law. Over 85% of all fertility centers are members of SART, and thus report to both organizations. Often SART publishes its statistics before the CDC, but the numbers should be the same.
One puzzling thing about these reports is that even though it’s currently 2011, the most recent national report available from SART covers the year 2009. This delay occurs because fertility centers must wait to determine whether a birth occurred. Therefore, the earliest that centers can report their 2009 data is the fall of 2010, roughly nine months after the previous year’s end. Once the data is reported to SART and CDC, it is then reviewed and verified to ensure its accuracy. While this review is a necessary piece of the process, it extends the release of the data by 16-18 months following the reported year.
Besides reporting national averages for the year, SART also provides access to the individual reports of each fertility center on its website. Often, fertility centers publish their individual success rates in brochures or on their websites. This data should match the information reported to SART and the CDC exactly – and it’s easy to check – because the SART database is searchable by zip code or state.
How is Success Determined? Pregnancy or Live Birth?
One of the reasons that the Fertility Clinic Success Rate Reporting Act was passed was to standardize the categories of information being reported. For example, the standardized categories make clear which data represent “pregnancies” and which represent “live births”. Without this distinction, fertility centers might categorize “success” as any positive pregnancy test, even if those pregnancies were miscarried or ectopic. While this might make “success rates” look higher, these results are irrelevant to someone seeking a child.
Some of the reporting categories used by SART are:
- Pregnancies per cycle
- Live births per cycle
- Live births per egg retrieval
- Live births per embryo transfer
- Single embryo transfers
- Cancellation rate of cycles
- Average number of embryos transferred
- Twin births and births with more than twins
These are definitions for some of the terminology used in reporting:
- Cycle – this means the start of medications with the intention of proceeding with IVF.
- Retrieval – the removal of eggs from the ovaries.
- Transfer – the placement of 1 or more embryos back into the uterus.
- Single Embryo Transfer – the placement of just one embryo back to the uterus. Shady Grove Fertility refers to this as eSET or Elective Single Embryo Transfer.
- Pregnancy – achieved when both blood testing and ultrasound show a pregnancy.
- Live Birth – just what is sounds like! This number will always be lower than the pregnancy rate due to the occurrence of miscarriage.
- Implantation Rate – the chance that any one embryo will implant into the uterine lining and result in a pregnancy or a live birth.
- Cancellation – An IVF cycle may need to be cancelled prior to completion. This could be due to insufficient or no eggs developing, no eggs fertilizing, or no embryos of sufficient quality to return to the uterus.
Comparing Apples to Apples
It’s natural for patients trying to decide between fertility centers to want to compare success rates between centers, but SART says these comparisons are not meaningful. SART states that comparing individual fertility center success rates is unreliable because factors, such as patient selection, patient medical characteristics, treatment approaches and program policies that can influence the statistics, vary from center to center. The clearest and most beneficial way to rate a center’s success is by comparing their individual success rates to the national SART averages.
Most people seeking fertility treatment have the same simple question – what are my chances of having a baby? – and the distinctions between the reporting categories can make it seem harder to figure out the answer. But these detailed statistics can tell us a lot about a fertility practice that can help consumers make informed decisions about where to receive treatment.
You can use a few key statistics to determine a fertility center’s success, and your chances of delivering a baby as a result of treatment.
1. What are my chances of having a baby if I start a cycle? For this answer, we would look at Live Births per Cycle. If you look at the graph below, you will notice that in Shady Grove Fertility patients ages 35 and younger, the live birth rate is 47.8% and live birth rates slowly declines as the age group increases. The good news is that your chances of success increase with each treatment cycle attempted.
2. What is the difference between Pregnancy Rate and Live Birth Rate? A pregnancy is determined when both a blood test and ultrasound confirm a baby. The live birth rate is defined when a patient delivers a child (or children). Because some pregnancies end in a miscarriage, the percentage of cycles resulting in pregnancies is usually higher than the percentage of cycles resulting in live births.
3. Does Implantation Rate Matter? We tend to look at two numbers very closely in reading the statistics – the Implantation Rate (IR) and the Single Embryo Transfer (eSET) rate. The implantation rate is extremely important to Shady Grove Fertility because it is a number that demonstrates the quality of our Center’s clinical and laboratory work. A program with good implantation rates should be able to transfer fewer embryos with the same pregnancy success rate. If they don’t, you will see rising multiple pregnancy rates. As desirable as a twin birth may sound after struggling with infertility,it is a riskier pregnancy.
4. What is the rate of Twins and Triplets Plus? Multiples pregnancies are higher risk and can result in higher rates of disabilities and other challenges for the child. If a center has higher than average numbers in these categories, it is a sign of trouble. Shady Grove Fertility is proud to have rates lower than the national average in both categories.
Shady Grove Fertility’s Commitment to Patients
Shady Grove Fertility is proud of our SART report. While these numbers are critically important to us and to our patients, our success at providing high quality ethical and personalized care to our patients is equally important to us. Our physicians, nurses and staff are dedicated to helping our patients achieve their goal of a healthy pregnancy and thus a healthy baby.
- SART 2009 National IVF Success Rates
- Shady Grove Fertility’s 2009 SART Succes Rates
- Center for Disease Control’s Assisted Reproductive Technology Page