National IVF Success Rates
You must think critically when looking at IVF success rates around the nation. We are a member of the Society for Assisted Reproductive Technologies (SART) who recommends patients against comparing IVF clinics using national data. In fact they don’t allow us to compare ourselves to other clinics and require us to put the following statement on our pregnancy rate pages.
“A comparison of clinic success rates may not be meaningful because patient medical characteristics, treatment approaches and entrance criteria for ART may vary from clinic to clinic.”
The differences they are referring to probably include some of the following:
- Patient medical characteristics: Some centers and geographic areas could be treating patients with specific medical disorders and characteristics not reflective of the general population or our patient population.
- Treatment approaches: All centers use different approaches to medical treatment. Differences in treatment approaches could be the intensity of the ovarian stimulation, differences in embryology laboratory procedures, differences in embryo culture media and differences in the number of embryos transferred.
- Entrance criteria for ART: Some centers use IVF as a last step in treatment and therefore are treating the most refractory patients compared to those centers who might use IVF as first line treatment who might be able to conceive with simpler forms of treatment.
- Poor Prognosis Patients: Some centers refuse to make IVF available to patients with a lower prognosis knowing their success rate will be lower and it will be included in their published results.
We are proud of the program we have developed. Our pregnancy rates are reflective of who we are and the choices we have made to maximize your care. We feel our approach is well balanced in providing high tech care to those that need it and simpler forms of treatment to those that don’t. Of all patients we see, two out of three start with simpler forms of treatment such as ovulation induction and intrauterine insemination.
Our IVF program at Coastal Fertility Specialists is based upon the latest ovarian stimulation protocols using recombinant gonadotropins to optimize both egg number and egg quality. The ovarian stimulation protocols are individualized based upon patient age, FSH level, prior IVF history, body mass index and a variety of other factors. This approach helps to maximize egg number and quality while minimizing ovarian hyperstimulation.
We have built and maintain a high quality embryology laboratory which provides high quality embryos to couples resulting in top tier pregnancy rates with mostly one embryo transfers. The Coastal Fertility focus on having one high quality lab rather than multiple lower quality labs is central to our mission of maximizing the chances of a healthy pregnancy not just a pregnancy. To an infertile couple, a multiple pregnancy may seem acceptable; however, multiple pregnancies result in a significantly higher risk of both maternal and fetal complications. Multiple births born to women at any age are at significant increased risk of autism, cerebral palsy, and many other birth defects.
In an effort to maximize the pregnancy rate and minimize the multiple pregnancy rate, our embryology lab uses 4th generation incubators, isolettes for gamete isolation and embryo grading along with the latest embryo culture media. All of our incubators are carefully calibrated for low oxygen tensions and CO2 levels to optimize the pH levels and maximize blastocyst formation and pregnancy rates. To minimize the number of embryos transferred and maximize pregnancy rates we commonly perform embryo transfers on the fifth day after egg retrieval, which is referred to as the blastocyst stage. This stage of embryo growth allows us to select those embryos with the best morphological features, thus allowing us to transfer the embryos that would result in the highest pregnancy rates. By transferring a smaller number of blastocyst embryos we are able to maintain our high clinical pregnancy rates while minimizing the multiple pregnancy rate.
Preimplantation genetic testing (PGT) is recommended to couples at increased risk for birth defect based on patient age and or family history. PGT is performed through embryo biopsies at the blastocyst stage with testing being performed with Next Generation Sequencing which is the highest resolution of testing currently available.
In a continuing effort to improve our IVF program, the physicians and staff frequently attend national and international conferences to present research and review the latest IVF techniques. We participate in both internal and external audits of our IVF program, have quarterly meetings to review outcomes and to obtain independent evaluations, second opinions and advice from all of our board certified physicians.