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Advanced Fertility Center of Chicago

Fertility, IVF and Egg Donation

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2011 IVF Live Birth Success Rates Available

by on Nov.25, 2012, under CDC Report on Fertility Clinic IVF Success Rates, IVF Clinic Success Rates, SART IVF Success Rate Report

The Fertility Clinic Success Rate and Certification Act of 1992 mandates that IVF clinics annually give their IVF live birth success rate data to the Centers for Disease Control and Prevention (CDC), a US government agency.

IVF cycles  from December 2011 would result in babies being born by about mid October. Then fertility clinics can call patients to get birth information by about November 1st and can submit it to SART and/or the government. SART releases its annual IVF success rate report in January to February. Therefore, the 2011 SART report should be released in January-February 2013. The preliminary CDC report is released several months later and the complete CDC report takes about a full year to come out.

In vitro fertilization clinics have 2 options for reporting outcome statistics to the government:

  1. They can report it to SART, who will publish it on their website (www.SART.org) and pass the data on to the CDC
  2. They can bypass SART and report to Westat, a statistical survey research organization that the CDC contracts with to obtain data from fertility clinics

The CDC publishes a thorough report (www.cdc.gov/art/ARTReports.htm), but it comes out several months later than the SART report for the same year.

Both the CDC and the SART reports show national averages as well as clinic-specific data for all reporting clinics. Unfortunately, some IVF clinics refuse to report their data, as required by federal law. They choose to be listed as a “non-reporting clinic” rather than let the public see their IVF statistics.

  • This suggests they have low success rates
  • Stay away from these clinics
  • A section of the CDC’s “National Summary and Fertility Clinic Success Rates” report lists all of the “non-reporting clinics”

We recently submitted our 2011 IVF live birth success rates to SART, as did most other US clinics. Our outcome statistics are shown below.

Our 2011 IVF Pregnancy and Live Birth Success Rates – Fresh Cycles
IVF statistics for January 1, 2011 through December 31, 2011
Age
Cycles
Started
Egg
Retrievals
Clinical Pregnancy Rate
Per Egg Retrieval
Live Birth Rate
Per Egg Retrieval
< 35
208
200
66.5%
60.0%
35-37
83
75
52.0%
45.3%
38-40
60
53
50.0%
33.3%
41-42
10
9 11.1% 11.1%

Egg Donation
Donor success rates

75 embryo transfers 81.3%
Per embryo transfer
80.0%
Per embryo transfer

 

Our 2011 Frozen Embryo Transfer Statistics
Frozen Transfer Statistics for January 1, 2011 through December 31, 2011
Age
Frozen Transfers
Clinical Pregnancy Rate
Per Transfer
Live Birth Rate
Per Embryo Transfer
< 35
45
73.3% 66.7%
35-37
20 55.0% 55.0%
38-40
11
54.5% 45.5%
41-44
2
50.0% 50.0%
Egg Donation
Donor success rates
30 76.7% 53.3%

Tight quality control is what makes the biggest difference in outcome statistics. We work hard every day to maintain quality control throughout our fertility practice.

  • The choice of the IVF stimulation protocol for the individual couple is important
  • The doctor must manage the stimulation with careful medication adjustments
  • The nursing staff needs to communicate doctor’s instructions effectively to patients
  • A properly performed egg retrieval procedure is important
  • The laboratory culture environment has over 200 variables affecting egg, sperm and embryo quality
  • A smooth and efficient embryo transfer procedure can be difficult and is a critical factor that affects chances for success
  • The challenge for the fertility clinic is to get and keep a grip on all of these areas

Do your research and find a clinic that you can trust to get the job done effectively.

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.
Richard Sherbahn MD

Richard Sherbahn, MD is a fertility doctor practicing in the Chicago, Illinois area. Connect with me on Google+

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Coenzyme Q10 and Fertility

by on May.26, 2012, under Age and Fertility, Chromosomal Abnormalities in Eggs, Egg quality, Low ovarian reserve

Fertility treatment fads and the internet

I’ve been in this field for 20 years and have seen fads come and go. The information exchange and communication between patients and doctors that the internet provides sometimes fosters proliferation of fads driven by rumors – rather than by science.

When I started practicing medicine in the early 1990’s, infertility patients came to the doctor and expected to be told what to do. They wanted some fertility tests done to find the cause for their infertility and then they wanted either intrauterine insemination treatment or in vitro fertilization, IVF to have their baby. There was no internet so couples could not research medical information on their own.

As the internet evolved, couples got more involved in deciding specifics of their infertility care. Most couples now use the internet to educate themselves about fertility testing and treatment options. I think this is great. However, there is a potential downside. It is difficult to separate the wheat from the chaff.  There are many worthless tests and treatments promoted and sold on the internet to anyone with a credit card.

When a study comes out and is published in the medical literature regarding a treatment option that might be beneficial the physicians will learn about the new option if it is potentially viable. Then, additional studies will be done to confirm or refute the results from the initial study. Doctors are used to the fact that one study showing a potential benefit from a new treatment option might not stand the test of time and be supported by additional studies done in other clinics.

However, in our news hungry world a study comes out reporting an interesting potential benefit for a new treatment – someone does a press release and it’s picked up on a news wire. Before long, women are discussing it in the infertility forums and on Facebook and in chat rooms as the new treatment option that everybody should be doing.

Coenzyme Q10 and fertility

I want to discuss coenzyme Q10, which is one of the “treatments” that patients are using on their own (often without input from their doctors) in an effort to improve their fertility potential or to increase chances for IVF success. Coenzyme Q10, often referred to as “Co Q10” is a substance that is needed for basic functioning of cells. It is a source of fuel for the mitochondria – which are organelles inside cells that are “power plants” that convert energy for the cell to use.

Interest in coenzyme Q10 as a supplement to improve fertility was sparked when a report from Canada said fertility in mice was improved when the mice were given Co Q10. The mice that were given coenzyme Q 10 before they were given ovarian stimulation made more follicles and better eggs compared to mice that were not given Co Q10. According to the researchers, the Co Q10 seemed to cause the older mice to produce eggs that functioned more like eggs from younger mice.

This study suggests the possibility of a fertility benefit for women with low ovarian reserve. As far as I know, this mouse study has not been repeated and there are not yet published studies of Co Q10 in women having fertility treatments.

Coenzyme Q-10 and egg quality

We all know the chances for pregnancy decline as female age increases after about 30 years old. We know that the decline has a number of causes, but the main problem is a decline in “egg quality”. Egg quality is an important concept involving several critical factors – none of which we can test or measure. One major component of egg quality involves the chromosomal status of the egg. Eggs from older women are more likely to be chromosomally abnormal than eggs from young women.

The human egg is a very large cell. It can be thought of as a big factory with half of the chromosomal complement of a normal human that is sitting and waiting for a sperm to deliver a very small package containing 23 chromosomes (the other half). When a sperm penetrates an egg and releases its package of 23 chromosomes, the switch to the “egg factory” is turned on and embryo development begins.

The process of firing up the factory and starting normal embryo development requires a lot of energy. Mitochondria are very tiny organelles within cells that generate a lot of the energy that cells need. Human eggs have more mitochondria and mitochondrial DNA than any other cell in the body.

What does any of that have to do with egg quality and fertility?

One theory speculates that part of the problem in older eggs is their decreased mitochondrial energy production. Taking that concept a step further, perhaps eggs could function more effectively and efficiently if something could be done to increase the number or health of the mitochondria in the eggs. Maybe the egg could do a better job of maintaining chromosomal normalcy if it had enough energy reserves.

From this came the logic that using dietary supplements of “mitochondrial nutrients” might improve egg quality.

What is coenzyme Q10?

Coenzyme Q 10, which is also known as ubiquinone, is a vitamin-like substance that is present in most cells. It is an antioxidant (meaning it inhibits the oxidation of other molecules). Sometimes, oxidation reactions produce free radicals which can start chain reactions in cells resulting in damage or cell death. So antioxidants can be good when they terminate the chain reactions before there is damage to the cell.

It is not considered a vitamin because all normal tissues in the body make their own CoQ10 so it does not need to be supplied in the diet. It is mainly present in the mitochondria and is a component of the electron transport chain that is involved in generating energy within cells in the form of ATP. The vast majority of the human body’s energy is produced in this way. Therefore, the high Co Q10 concentrations are found in cells with high energy requirements – heart, liver, kidney, etc.

It has been estimated that the average daily intake of Co Q10 is about 3 to 6 mg per day, which mostly comes from meat consumption. The recommended dosage of Co Q10 supplementation varies greatly. The suggested dose is usually between 50 to 600 mg daily in divided doses.

There is controversy as to what the best dose of CoQ10 is for various medical conditions. It is often given at a dose between 100 mg and 300 mg per day. There is some evidence from studies that is safe at a dose of up to (at least) 1200 mg per day.

Should women with fertility problems take Co Q10?

Physicians are trained to practice evidence-based medicine. What that means is that we want well-controlled studies supporting that a treatment is beneficial before we recommend it. In the case of coenzyme Q 10 we can’t justify its use for improving fertility in women based on existing evidence.

On the other hand, there’s no evidence that there is harm from using Co Q10 and it is unlikely that there would be harm since this enzyme is present in every cell in the body and is produced within cells regardless of whether it is present in the diet or not.

So women have read about it and have taken CoQ10 with the idea that they will produce more eggs with ovarian stimulation for IVF and their eggs will get better and perform like younger eggs.

  • Even if it doesn’t help, it’s unlikely to hurt – and CoQ10 is not expensive
  • Most fertility doctors (including me) are fine with their patients taking Co Q10 if they want to
  • Hopefully, a carefully controlled study will be done and published in the medical literature so we will understand more about any potential benefit of  Co Q10 for women with fertility problems.
Richard Sherbahn MD

Richard Sherbahn, MD is a fertility doctor practicing in the Chicago, Illinois area. Connect with me on Google+

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2010 SART IVF Success Rate Report Available Online

by on Feb.22, 2012, under IVF Clinic Success Rates, SART IVF Success Rate Report

2010 IVF success rate report released by Society for Assisted Reproductive Technology

Couples with fertility problems that might consider having in vitro fertilization treatment have a valuable resource in the SART success rate report. This study comes out annually. The report for IVF treatments performed in 2010 was just released.

Clinics collect their outcome data live births and report the outcomes of all IVF cycles to SART by November of the following year. SART then compiles the data and publishes it by about 3 months later. This allows the public to study IVF success rates or egg donation success rates for any specific clinic.

Not every IVF program in the US reports to SART but the large majority do. All clinics are required by law to turn in their outcome statistics to the CDC (US government). The CDC IVF report is then published annually with information on all clinics that follow federal law and give their data to CDC (some refuse to report it).

The CDC report on IVF clinic statistics is an excellent resource – but it comes out about 9 months later for any given year than the corresponding SART report.

Patients needing fertility treatments should investigate IVF success rates at clinics they are considering for treatment. Success rates vary dramatically between programs – do not assume that all centers are equally capable at getting you pregnant.

Although there can be many variables involved in success rates, the overall quality of the IVF program and the IVF laboratory are 2 of the most important factors impacting the chance of success.

The SART report shows clinic specific data on live birth outcomes that are categorized in several ways.

By female age

  • Female age has a significant impact on fertility
  • SART breaks down in vitro fertilization success rates based on female age group for cases with women using their own eggs
  • Our live birth success rate for 2010 for women under age 35 was 60.3% per egg retrieval (fresh embryos)

By own vs. donor eggs

  • Egg donation success rates are higher than for cases using own eggs
  • Our live birth success rate for 2010 using donor eggs was 81.6% per embryo transfer (fresh embryos)

By fresh vs. frozen embryos

  • Statistics for embryo transfers using frozen embryos are shown separately from cycles with fresh embryos
  • Success rates with frozen embryos have improved significantly in recent years
  • Using frozen embryos, our live birth success rate for 2010 for women under age 35 was 52.0% per embryo transfer
  • Using frozen embryos, our live birth success rate for 2010 using donor eggs was 70.0% per embryo transfer

PDF version of  Advanced Fertility Center of Chicago’s 2010 SART report

Our IVF success rates vs. national average for 2010Our donor egg success rates vs. national average for 2010


To see the 2010 SART report and check IVF live birth success rates:

  • Go to the SART website
  • Click on the state that you want on the US map
  • A list of all SART member clinics in that state will come up
  • Click on the clinic you want to see success rate results for
  • Click “ART Data Report” (at bottom) – that clinic’s IVF results for 2010 will come up
  • If you want to see another year, select it from the pull-down menu

If a clinic that you are considering has low success rates compared to national averages or other clinics in your area – go to a clinic with higher success rates. It probably will give you a better chance to have a baby.

Our website has links to the CDC and the SART reports and discusses them in more detail with examples showing how to interpret clinic-specific and national average tables.

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.

Richard Sherbahn MD

Richard Sherbahn, MD is a fertility doctor practicing in the Chicago, Illinois area. Connect with me on Google+

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Using frozen donor eggs for egg donation

by on Jul.31, 2011, under Age and Fertility, Donor Eggs, Egg Banking, Egg Donation, Egg Donation Cost, Egg Freezing, IVF Clinic Success Rates, Oocyte Cryopreservation

Egg donation has been utilized to help infertile couples since the early 1980s. Donor egg IVF utilization has continued increasing as more couples delay childbearing until their late 30s and 40s. In the United States in 2009 there were over 15,000 cycles using fresh donor eggs reported to SART (Society for Assisted Reproductive Technologies) from their member clinics. Links to the SART and CDC IVF and donor egg success rate reports

Until the last few years all donor eggs cycles were done with fresh eggs retrieved and fertilized the same day with the male partner’s sperm. Over the years egg donation using fresh eggs has become highly successful at some fertility clinics in the US.

Live birth rates with fresh donor eggs are over 70% per fresh transfer procedure at the best egg donation clinics. Success rates at these same donor egg programs using fresh eggs are over 50% for live birth per transfer using a single embryo for transfer. This approach almost totally eliminates the risk for multiple pregnancy.

Our donor egg live birth success rates

In recent years the techniques for freezing and thawing eggs have advanced significantly. As a result of these advances, success rates at some frozen donor egg banks has increased from about 10% success in the past to approximately 50% – at least this is what they claim.

Accordingly, business models have developed for frozen donor egg banks. Egg banks sell frozen donor eggs on a per batch or per egg basis. This can make the cost of using frozen eggs seem to be less than the cost of egg donation with fresh eggs. However, there are some significant problems with this approach.

  1. Uncertain and relatively low success rates – with low success rates the cost per baby is actually higher
  2. Uncertainty about long-term health issues for the children born from frozen eggs

(continue reading…)

Richard Sherbahn MD

Richard Sherbahn, MD is a fertility doctor practicing in the Chicago, Illinois area. Connect with me on Google+

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2009 SART IVF Clinic Success Rate Report

by on Mar.13, 2011, under IVF Clinic Success Rates, SART IVF Success Rate Report

  • A few days ago SART (Society for Assisted Reproductive Technologies) released its 2009 IVF Success Rate Report
  • This report comes out annually and provides clinic specific in vitro fertilization success rates for all SART member clinics in the US
  • The report includes a national summary which shows national averages for IVF success rates broken down by the age of the female partner
  • It also has live birth rates for IVF with donor eggs

This report is a useful resource for couples pursuing fertility treatment. Success rates are significantly different between programs. When you go through an IVF cycle you are not getting the same treatment at every program.

It’s not like going out and buying a Jeep:

  • If there is a Jeep dealer closer to home, or a little cheaper – then a Jeep is a Jeep, so buy it there
  • However, IVF is not a commodity
  • IVF at one clinic may result in an average success rate of 25% while at another clinic it might be 60% for the same age group
  • In vitro fertilization at “Clinic A” does not equal IVF at “Clinic B” – so do your research

Advanced Fertility Center of Chicago vs. USA average IVF success rates

Our IVF success rates
Our egg donation success rates

The clinics must turn in their data every year (to SART and the CDC)  in November for the IVF cycles performed during the previous calendar year. SART then takes a few months to prepare the report and publish the results on the web.

The CDC (Centers for Disease Control and Prevention), a US government agency, also publishes annual IVF success rate reports

  • However, release of the CDC report is delayed by about 8 to 10 months after the SART report
  • The CDC’s report is more comprehensive and includes more clinics with additional analysis of data beyond clinic success rates
  • The drawback of the CDC report is the additional delay before publication

To go to the 2009 SART report and check IVF live birth success rates for any SART member clinic, follow these steps:

  • Click this link: www.sart.org
  • Click on the orange button “IVF Success Rate Reports”
  • Click on the state that you want on the US map
  • A list of all SART member clinics in that state will come up
  • Click on the clinic you want to see results for
  • Click next to “ART Data Report” (at the bottom) and that clinic’s IVF success results for 2009 will come up

Study the report in the area relevant to you – own eggs and age 40, or donor eggs, etc. If a clinic is missing from the SART or CDC reports it is probably a bad sign. Find out why they did not report – or go elsewhere. Buyer beware.

If you check the success rate information for a clinic you are considering for treatment and find that they are low compared to national averages or other clinics in your area – go to a clinic with higher success rates. It would likely increase your chance to have a baby with IVF.

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.
Richard Sherbahn MD

Richard Sherbahn, MD is a fertility doctor practicing in the Chicago, Illinois area. Connect with me on Google+

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Welcome to the
Advanced Fertility Center of Chicago

Richard Sherbahn, MD is a Board Certified Reproductive Endocrinology and Infertility specialist.

Dr. Sherbahn founded the Advanced Fertility Center of Chicago in 1997.

He will post regularly about fertility issues.

Dr. Richard Sherbahn
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