- Age and Fertility
- CDC Report on Fertility Clinic IVF Success Rates
- Chromosomal Abnormalities in Eggs
- Donor Eggs
- Egg Banking
- Egg Donation
- Egg Donation Cost
- Egg Freezing
- Egg quality
- Embryo freezing
- Embryo implantation
- Fertility Preservation
- Frozen embryo transfer
- IVF Clinic Success Rates
- IVF Cost
- IVF Poor Responders
- IVF success rates
- Low ovarian reserve
- Micro IVF
- Mild IVF
- Mini IVF
- Minimal Stimulation IVF
- Multiple Pregnancy
- Number of IVF Embryos to Transfer
- Oocyte Cryopreservation
- Ovarian Reserve
- Ovarian Reserve Tests
- Pregnancy Complications
- Preimplantation Genetic Screening
- Prelude Fertility
- Single Embryo Transfer
Fertility, IVF and Egg Donation
The Society for Assisted Reproductive Technology (SART) and the Centers for Disease Control (CDC) have both recently released their 2016 IVF success rate reports and published them online. These reports, which are released annually, allow anyone to investigate either IVF or egg donation success rates using fresh or frozen embryos at almost any clinic in the United States.
Federal law requires that all US in vitro fertilization centers submit their data annually so that it can be published for review by people who are considering in vitro fertilization treatments. Almost all clinics report their data to the government although a small percentage refuse to report it. When the federal government passed a law requiring annual submission of the data they probably assumed that doctors would comply and they did not make a specific punishment for not following the law. The fertility clinics that do not report probably do not want the public to see their success rate data. That is not a good signal about their success rates. I suggest staying away from any fertility clinic that does not report their data to the government.
The Society for assisted reproductive technology (SART) is an organization that the majority of fertility programs are members of. However, membership is voluntary and not all clinics are SART members. Therefore, is not required by law to report IVF data to SART but it is required to report to CDC.
The SART and CDC reports are useful tools for potential consumers of in vitro fertilization, egg donation and surrogacy services because they allow comparison of outcomes at different programs. The reports can be utilized to investigate fertility clinics in terms of their success rates, multiple pregnancy rates, treatment volumes within different age groups and within different treatment options such as using own eggs, using fresh donor eggs or using frozen donor eggs.
The SART site allows you to pull up individual programs results and you can apply various filters to the data if desired. These filters can be useful. For example, you can put a filter on the data to see only those cycles that used PGD or PGS preimplantation genetic screening, etc..
Link to SART site
The CDC site allows you to download a spreadsheet with every program’s data. This could be a somewhat overwhelming method to use – depending on how much familiarity one has with spreadsheets. Also, unfortunately the column headings in the spreadsheet are not intuitive so you need to use the “Clinic Table Dictionary” to find out what the column headings in the sheet mean. Otherwise, most of them will not make sense.
Link to CDC site
However, the spreadsheet format is powerful in that it allows a convenient way of sorting the data to list clinics in order. For example, you could choose to sort on “live birth rate per embryo transfer”, or “live birth rate per cycle”, etc.. With 463 clinics’ data in one spreadsheet it is big – but it could be cut down to the local clinics that someone might want to compare, for example.
Consumers of in vitro fertilization, egg donation, and surrogacy services should utilize these reports before choosing a clinic so they know how successful that program is as compared to other options. People that live in larger cities will usually have several fertility clinics nearby as an option to go to.
Obviously, some people might only have one fertility clinic within a hundred miles of their home. In such a case it may not be as important to compare success rates. However, some couples will travel to another state to have the IVF or egg donation services performed. We have many couples every year that travel from distant states and even from other countries to have their fertility treatments with us.
We are proud that our success rates for 2016 are well above national averages. Our success rates have been higher than average every year for the past 20 years in a row. Superior quality control throughout the entire program is the main factor allowing some clinics to have success rates substantially above average. On the other hand, poor quality control will drag success rates down. Common quality control issues involve problems with ovarian stimulation regimens, the IVF procedures (egg retrieval and embryo transfer) and the laboratory embryo culture systems.
The CDC spreadsheet does not show national averages and so that data cannot readily be compared to this CDC report national averages. Later in the year, the CDC puts out another report for the same year of data which is more comprehensive and includes charts that drill down into certain aspects of the data and also includes national averages. However, that part of the report has not yet been released by the CDC. Below are some charts utilizing the SART data on national averages and our program’s SART data showing comparisons.
There is also a page on our website that discusses how to utilize and understand the SART and CDC report data.
The CDC recently released the new IVF success rate report that shows individual IVF clinic’s IVF success rates as well as national averages. This report covers IVF treatments performed in 2011. It is available to the public on the CDC website as a PDF or as a downloadable Excel spreadsheet.
The CDC IVF success rate report shows success rates for individual IVF centers in the United States. This allows couples struggling with infertility to evaluate live birth success rates for any fertility program.
The report also includes a page showing national average success rates for all categories of patients. I suggest that before having in vitro fertilization performed anywhere, couples should look up the clinic in the CDC report and compare its success rates to national averages. They should also compare the numbers to other clinics in their area.
The CDC report also shows the number of cases done in various diagnostic categories and age groups. So, for example, if someone needs IVF with donor eggs they should look at how much experience the program has with egg donation as well as the success rates using donor eggs.
For example, some IVF programs will do a significant volume of IVF using women’s own eggs but do very few cases with donor eggs. This should be an important consideration for patients needing IVF with donor eggs.
The CDC report is organized by state and within the states are listed alphabetically by city where the clinic is located. All IVF programs are required by federal law to report their IVF outcome data to the government for reporting to the public. Some clinics choose to violate federal law and not report their data.
Unfortunately, when the government passed the law they did not make a specific punishment for clinics that violate this law. Therefore, at this time the punishment for not reporting is only to be listed as a “non-reporting clinic”. Some clinics prefer to be listed as a non-reporting clinic rather than to have the public see their IVF statistics.
This obviously suggests that these programs have something to hide. Most likely they have low IVF success rates and do not want the public to see the numbers. I recommend couples stay away from any program that is breaking federal law by not reporting its IVF statistics.
The CDC report also shows the diagnosis categories of patients that are treated with IVF. It shows the percentage of cases that had male factor problems, the percent with tubal factor, the percent with diminished ovarian reserve, with endometriosis, unexplained infertility, etc.
The success results are broken down by age group. Less than 35 is the youngest age group, the other age groups are 35 to 37, 38 to 40, 41 to 42 and 43 to 44. For donor eggs all recipient ages are lumped together. This is because there is almost no difference in outcome statistics based on the age of the recipient female when using (young) donor eggs.
Results are shown on a per cycle basis and on a per transfer basis in the 2011 CDC report. A “cycle” is defined as all cases that started stimulation medications with the intention of having IVF performed. Not all patients to start cycles make it to the egg retrieval procedure because some will be canceled for a very poor response to the ovarian stimulating drugs.
Cancellation criteria will very between fertility clinics but most clinics in the US want to see a minimum of three or four mature size follicles before proceeding to the egg retrieval procedure. With less mature follicles than that the success rates are extremely low.
In the past the CDC report showed statistics on a per egg retrieval basis as well. It has always been traditional to report outcomes on a per cycle, per egg retrieval, and per embryo transfer basis. However, for some reason the CDC dropped the per egg retrieval reporting from the 2011 results page.
I think this is unfortunate because the live birth rate per egg retrieval shows how good the clinic is at getting couples pregnant if they make it to an egg retrieval procedure. There are number of reasons aside from cycle cancellation for low response to stimulation that a patient might not have an embryo transfer procedure.
For example, they could have all embryos frozen (for various reasons), or they could have poor embryo development resulting in no viable embryos for transfer.Fortunately, the other IVF success reporting system (SART IVF success rate report) still shows the live birth rate per egg retrieval statistic.
The CDC IVF report is released in 3 parts.
- A spreadsheet with all reporting clinics success rates is released in early summer
- A PDF document with statistics for all reporting clinics is released in late summer
- The complete report with clinic success statistics and other compiled statistics based on the aggregate national data is released in late winter (early 2014 for the 2011 report)
Overall, the CDC has put out an excellent report that allows consumers of IVF services to examine success rates at clinics they are considering.
- IVF success rates vary significantly between programs
- Couples should make an informed choice about where to have IVF after studying clinic success rates in the CDC 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.
- Couples needing fertility treatment should check and compare IVF success rates at any fertility clinic they are considering
- Before you do IVF, know the success rate statistics at programs in your area
- Video shows how to use the SART website to check and compare IVF success rates at fertility clinics
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:
- They can report it to SART, who will publish it on their website (www.SART.org) and pass the data on to the CDC
- 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
Clinical Pregnancy Rate
Per Egg Retrieval
Live Birth Rate
Per Egg Retrieval
|75 embryo transfers|| 81.3%
Per embryo transfer
Per embryo transfer
|Our 2011 Frozen Embryo Transfer Statistics
Frozen Transfer Statistics for January 1, 2011 through December 31, 2011
|Clinical Pregnancy Rate
Live Birth Rate
Per Embryo Transfer
Donor success rates
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.
I see a lot of couples that fail IVF at other in vitro fertilization programs and then come to us for their 3rd or 4th or 5th IVF attempt. They seek an IVF clinic that can give them a better outcome. Recently I’ve been hearing a similar story from couples that have failed at certain other IVF clinics in the Chicago area.
These couples asked their fertility doctor why our clinic (Advanced Fertility Center of Chicago) has higher IVF and donor egg success rates than they have. They have been told that “Dr. Sherbahn cherry picks the best patients and does not treat patients with a low chance to get pregnant”. In other words they are accusing me of turning patients away with a low chance for pregnancy in order to cherry pick only the best patients and thereby artificially pump up our success rates.
It is a total crock. Patients that fail IVF again and again are likely to do IVF related research on the internet. They will find the CDC and SART websites where they can see if another clinic in their area has better pregnancy rates than the program where they failed.
- People are often motivated enough at that point to drive farther to a clinic that might give them a better chance for success.
- Therefore, people that fail and often have egg quality problems or other issues holding back their success will tend to switch to programs with higher success rates after they have done research.
- This results in programs like ours with higher than average success rates getting more patients with previous failures – which tend to be the most difficult cases.
- As a result, we will get relatively fewer “easy” cases
We do not send patients away or tell them we will not do IVF on them unless they are menopausal or otherwise clearly have a very low chance of success. I believe that if the couple has about a 5% or better chance of success and has been educated about their chances – we should allow them to cycle here. Taking patients with a 5% chance of success is certainly not “cherry picking”
- Some fertility specialists with big egos and poor quality IVF programs either just can’t accept the fact that their IVF programs aren’t very good – or perhaps they’re in denial and really believe that other programs have better success rates because they “cherry pick”
- Either way it’s pitiful
The clinics with low success rates often say that the reason IVF success rates are different between clinics is because:
- Patient populations are different between clinics
- Criteria for canceling IVF stimulation cycles are different
- The number of embryos transferred is different
- The percentage of single embryo transfer cases performed is different
Because these things can be different between clinics they claim that comparing success rates is not valid. However, just because comparisons are not perfect does not mean that comparisons should not be made. We cannot expect 100,000 IVF patients coming to 500 clinics across America to all have equal potential for a successful pregnancy. Every case is different, every egg and every sperm is unique and even the uterus can vary to some extent.
- However no clinic gets all the good cases, and no clinic gets only bad cases
- A mix of patients will present themselves to every clinic for treatment
If we look at success rates of clinics in the US according to the CDC and SART 2008 data sets (see graph below), we see a range of live birth success rates for cycles using fresh donor eggs from 25% to 81% per transfer. The national average for 2008 was 55% per transfer.
The Centers for Disease Control and Prevention, a US government agency, has just released a preliminary version of its 2007 Assisted Reproductive Technology (ART) Report. It expects to release the final version in December.
The Society for Assisted Reproductive Technology (SART) released its version of the report on 2007 IVF cycles several months ago. However, clinics are not required by law to report to SART. They are required to report to the CDC. Therefore, the CDC report shows success rates for more clinics than the SART report does.
The CDC report covers data from 430 fertility clinics. Over 142,000 assisted reproductive technology (or IVF) cycles were done at these “reporting clinics”.
There were (as always) some fertility clinics that broke federal law and refused to report their data. These IVF clinics are referred to as “non-reporting clinics”. If fertility doctors will go so far as to break federal law to keep their IVF outcome statistics from the public – those “non-reporting clinics” most likely have very low success rates.
Before you choose a fertility clinic for IVF – check success rates.
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.
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