Evaluating and Comparing Program Statistics
The following information regarding an IVF
program should be considered:
1. Are there parameters, such as age or FSH
level that exclude patients from participation
in the program?
For example, a program that excludes all patients
above a certain age and/or with decreased ovarian
reserved (borderline or elevated FSH) may have
better statistics and lower cycle cancellation
rates than a program which accepts even the most
difficult cases. At Penn Fertility Care, the success
rates are among the highest in the region, even
though we do not have a strict inclusion policy
and we do not have exclusion criteria for consultation.
2. What is the mean number of embryos transferred
per fresh IVF cycle and what is the high order
multiple pregnancy rates (triplets or more)?
Responsible programs should try to maximize
their pregnancy rates while minimizing the high
order multiple pregnancy rates. For example, does
a particular program transfer more embryos to
achieve a similar or, sometimes, even lower pregnancy
rate? This may indicate sub-optimal laboratory
conditions, or a less refined embryo transfer
technique, which usually results in lower viability
rates for the embryos. Painstaking laboratory
quality control and continuous updating of procedures
as advances in the science of IVF occur are key
in improving a program's success.
It should be pointed out that studies have clearly
shown that increasing the numbers of embryos transferred
to greater than 3, does not substantially increase
the pregnancy rates but increases the high probability
of multiple pregnancy rates. At Penn Fertility
Care, we have consistently transferred the fewest
number of embryos in the region and among the
fewest in the country, while maintaining high
pregnancy rates and very low high order multiple
pregnancy rates.
3. What are the frozen embryo pregnancy/delivery
rates and what are the guidelines for freezing
embryos?
This is key to an outstanding program and
goes hand in hand with the goals of improving
success rates while minimizing the high order
multiple pregnancy rates. There is no question
that as pregnancy rates from fresh embryo transfers
have improved, attention should be drawn to improving
procedures for freezing and thawing embryos in
order to maximize the number of pregnancies a
couple can achieve from a single egg retrieval.
In addition, increased pregnancy rates from frozen
embryo transfers are an indirect indication of
high quality laboratory and transfer procedures.
At Penn Fertility Care, success rates from frozen
embryo transfers are approximately double the
national average (last published national statistics
2000), are the highest in the region and among
the highest in the country.
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