- 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
- Preimplantation Genetic Screening
- Prelude Fertility
- Single Embryo Transfer
Fertility, IVF and Egg Donation
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.
There are some in vitro fertilization clinics in the US that market aggressively for mini-IVF or micro IVF (also called mild or minimal stimulation in vitro fertilization). Some claims regarding the benefits of mini-IVF are exaggerated or completely untrue. This post clarifies some issues regarding standard vs. mini IVF.
Mild IVF (or micro, or mini IVF) seems to be slowly growing in popularity over the last few years. Is it a good fertility treatment?
- The basic concept is to do in vitro fertilization after a low level of ovarian stimulation with oral medications (possibly with some “low dose” injectables as well).
- This is in contrast to the usual method of ovarian stimulation for IVF which involves more aggressive stimulation of the ovaries with multiple injections over about 8 to 15 days.
- The standard method of stimulating is done in order to try to get about 10 or more eggs to work with for in vitro fertilization.
- The IVF cycle cost for mild IVF (including medications and everything) should be less than the total cost for standard in vitro fertilization
- However, the success rates for standard IVF are much higher
- Success rates with mild in vitro fertilization are much lower – often in the range of about 5% to 15% per attempt, depending greatly on the age of the female
Why do we try to get so many eggs for “standard” IVF?
IVF success rates are much higher with a “good” number of eggs due to the substantial drop-off that is seen in early embryo development.
The chart below shows the average number of eggs, mature eggs, fertilized embryos, “good” embryos on day 3, blastocyst embryos on day 5, etc. in three age groups of women at our clinic.
- If there are extra embryos available for freezing, we freeze on day 5 and day 6 (possible freezing shown by purple arrow going up).
As shown in the chart, in the average case there is progressive drop-off over time with in vitro fertilization. Human reproduction is not extremely efficient – if we were mice or cows we would be efficient reproducers. Alas, we are not so lucky – we are stuck being human…
- We expect drop-off in the eggs and embryos in the fertilization and development process
- Therefore, having more eggs at the beginning makes it more likely to have at least one embryo at the end that is strong enough to make a baby
- Read more about the IVF process and how it increases efficiency of human reproduction
In the United States it is very easy to investigate IVF success rates for all in vitro fertilization clinics
There are two websites that report IVF success rates annually to the public:
- CDC website (Centers for Disease Control and Prevention)
- CDC is a US government agency
- SART website (Society for Assisted Reproductive Technology)
- SART is an organization dedicated to the practice of IVF in the US
- Links to these sites that report IVF success rates
The CDC IVF Success Rate Report for 2008 report has not yet been released. In vitro fertilization statistics are currently available from the CDC for 1999 through 2007.
In late February 2010 the Society for Assisted Reproductive Technology (SART) released the IVF Success Rate Report for 2008 cycles.
The SART report is released every year on the web and is available to the public. Almost all reputable in vitro fertilization centers are members of SART. Members are required to submit their in vitro fertilization data annually. Each clinic has its own listing page that shows its success rates on the SART website.
To view any clinic’s success rates through SART:
- Go to the SART website
- Click on IVF Success Rate Reports
- On the map, click the state that you are interested in.
- A list of all reputable SART member clinics in that state comes up.
- Click on any individual clinic – a page called “Clinic Contact Information” appears. At the bottom click the link next to “ART Data Report”. You will go to a page showing that center’s in vitro fertilization success rates for 2008.
- To see the center’s IVF statistics from a previous year, use the pulldown menu at the upper left where it says “Select Year”.
Although clinics with low success rates don’t mention it, there are large differences in success rates between clinics
There are number of reasons for this, but the biggest difference between different clinics is the degree of quality control within the system.
Patients often ask me why our success rates are so high. The answer is simple. (continue reading…)
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.
Couples with infertility often need IVF to get pregnant.What should they know about IVF clinic success rates?
- An interesting and unusual aspect of IVF is that there is a definitive outcome for each procedure.
- When an IVF cycle is done there is a baby born from it – or there is not. Therefore, keeping track of (and comparing) IVF live birth success rates is very straightforward.
- Medical treatments in general rarely have such “black and white” outcomes.
- Another unique aspect of IVF is that (in the US) all IVF clinics are required by federal law to report their in vitro fertilization success rates annually to the government. The CDC, a US government agency produces a report called the “Assisted Reproductive Technology (ART) Report” detailing IVF success rates for all individual clinics.
- This report is commonly called the CDC IVF success rate report. It is released to the public on the web every year (usually in December or January).
- Another useful report, the SART report (Society for Assisted Reproductive Technology), is very similar to the CDC report – and it is released about a year earlier. However, clinics are not required by law to report to SART – so some clinics are not listed there.
- These 2 annual reports allow consumers to view and compare IVF success rates for reputable fertility clinics.
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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