Thank you for your thoughtful comments. They are i...

2009-06-08T20:47:28.367-07:00

Thank you for your thoughtful comments. They are indeed all valid., I would however respectfully point out that since outcome is the litmus test of quality control, this is where we need to start. While other factors relating to structure and process such as the credentials of the IVF physician and the embryologists, equipping of the facility itself and the protocols and procedures in use are undoubtedly all relevant they really only come into [play once there is assurance that the IVF program has an “acceptable” success rate,

It is not rocket science. All that it would take would be for an authoritative body to mandate/decree that every single case where an IVF cycle is to be initiated, be pre-registered electronically and that failure to do so would prohibit the IVF program from receiving patient or third party reimbursement for services rendered to that patient. You can be sure that enlightened self interest would persuade every IVF program to so register every patient treated. Once pre-registration of all IVF patients is assured, the most important variable necessary to serve as a denominator in generating reliable IVF statistics would be in place (i.e the number of cases being treated). .From that point on it would be a simple matter to make certain that each treated case is tracked with regard to who/how many, undergo(es) egg retrieval , the number of embryos transferred per patient and the number of embryo transfers performed. From this data, pregnancy rate, miscarriage rate ,live birth rate multiple birth rated (twins ad high order multiples), prematurity rate, rate and type of birth defects etc, would be simple to arrive at.

All that would be needed to compel full compliance by all IVF practitioners and programs would be the will and resolve to mandate such compliance.

Once knowing exactly who and how many patients initiated a cycle of IVF it would be a simple matter to classify cases in to categories of complexity based upon: a) the type of procedure performed, b) number of prior IVF failures; c)age of the patient; d)cause of infertility and, e)the woman’s ovarian reserve.

The system is broken and it needs fixing. There is simply no excuse for the status quo ton continue. But as always, consumers don’t always get what they deserve…they get what they negotiate. This can readily and easily be rectified if only our governing bodies can be persuaded to redirect their priority from placating the IVF medical community to serving the needs of their mandate….....i.e. consumers.

Geoff Sher

Thank you for this post -- it's an excellent s...

2009-06-08T16:40:00.017-07:00

Thank you for this post -- it's an excellent summary of the issues of IVF 'success rates' and how clinics manipulate those numbers, including some things I'd never thought of.

As a woman currently assessing clinics and my own options, you've covered many of the reasons why I'm not making my decision based on such statistics. It's unfortunate, but the stats are - to my mind - a futile indicator of the best clinic for my care.

What I've found far more useful (though obviously not a preferable choice to "honest IVF outcome reporting" like we'd all prefer) is seeking out other women's experiences in different clinics. Were they well-informed and well-cared for? Did they feel their interests were paramount to the clinic, rather than simply their statistical chances? Furthermore, I've been looking into the doctors themselves, their education, their experience, their published works. And finally, (and this is one thing I haven't had much luck with) I want to know specifics of their lab standards, the training of their embryologists, etc.

Like anyone else trying to make an educated choice (especially as a 'consumer' of something as expensive as IVF, as I have no insurance for this), I'd much prefer some clear and accurate statistical reporting to factor into my decision, but that's just not available. And if I were to use the stats that are available to factor into my decision, I think it's likely that I'd end up discriminating against excellent clinics, either because they're reporting their stats accurately, or because they take a chance on clients that might have special obstacles to getting pregnant.

As a 39 year old, I have a lot of respect for clinics willing to risk their statistical reports in an effort to get a client pregnant who is my age or older. :)

Comments on IVF Authority: IVF Success Rates: SART Reporting Falls Short

Thank you for your thoughtful comments. They are i...

Thank you for this post -- it's an excellent s...