An Explanation of IVF Success Rates
Following passage of the Wyden bill in 1991, fertility programs in the United States were required to report their in vitro fertilization (IVF) pregnancy data to the Centers for Disease Control (CDC). This bill was intended to give the consumer a means of evaluating a particular IVF program. While the majority of programs in this country do report some do not. The penalty for not reporting is minimal – these programs are simply listed by the CDC as non-reporting. Reporting programs are subject to unannounced audits by qualified embryologists to verify data. At the Florida Institute for Reproductive Medicine over the last 21 years, we have been audited on two occasions and have passed both. A program not reporting their data to the CDC can report whatever data they wish, knowing they are not going to be audited. For that reason, it is wise to avoid any non-reporting program. To check and see if a program is a reporting program, check the website www.cdc.gov/art/art2010 (/art2009, /art2008, etc). I would suggest checking for at least the last three to four years as some clinics may report their data only when it is favorable.
When evaluating IVF success rates, it is important to look at live pregnancies from both fresh and frozen cycles. Some programs may report clinical or chemical pregnancy rates, approximately 5-20% of these pregnancies will end in miscarriage. Probably the biggest difference in cumulative pregnancy rates between programs is the difference with cryopreserved embryos. At the Florida Institute for Reproductive Medicine our fresh and frozen embryos have consistently been in the top ten percentile of programs nationwide. When evaluating pregnancy rates, it is also very important to look at the average number of embryos transferred. Many programs reporting very high pregnancy rates are achieving these results by transferring inappropriately high numbers of embryos. This practice inevitably results in a high percentage of multiple pregnancies. Multiple pregnancies are associated with increased morbidity and mortality to both fetuses and mother. At the Florida Institute for Reproductive Medicine for most individuals 38 years or less we are transferring two day 5/6 blastocyst embryos. For individuals less than 35 who are in a very good prognostic category we frequently will transfer a single blastocyst. For women older than 38 we may transfer up to three day 5/6 blastocyst embryos.