Whether you’re looking at fertility centers because you’ve struggled to get pregnant on your own or because using assisted reproduction is your only path toward parenthood, undoubtedly your number one question is “how successful are they?”
Which, quite frankly, is a loaded question, because there are so many different ways to define success. For example, any (or all) of the following factors could be used to measure success of a fertility center:
- Number of IVF cycles performed each year
- Number of cycles that result in egg retrieval
- Number of cycles that result in embryo transfer
- Number of pregnancies achieved
- Number of babies born
And to add to the data, there are many different factors that can impact IVF success rates:
- Average age of women undergoing treatment
- Health history of the women and men seeking treatment
- Number of women using donor eggs
- Stimulated versus natural cycles
- Number of fresh versus frozen transfers
- How patients are screened for their suitability for fertility treatment
- How many cycles employ preimplantation genetic screening
And so on. There are many ways to parse the data as it relates to IVF. And although the vast majority of fertility centers operate because they truly want to help people realize their dreams of parenthood, we can’t discount the fact that fertility centers, like any other business, have to make a profit. They are entrepreneurial corporations just like Uber or Google or Microsoft. Yes, they want to solve problems for their customers (and perhaps that’s true for fertility centers more so than any other type of company), but the bottom line, just as with any other business, is profit.
Which is not to say that fertility centers are out to get rich at the expense of their clients. I do not believe this is the case. It does mean that fertility centers, like other businesses, have to advertise or at least maintain a prominent web or community presence to attract new patients. And what’s one of the key facts about themselves they can advertise? Their success rates, of course.
But while quoting any one particular success rate might make for a straight-forward advertising campaign, as a consumer it’s not a particularly good way to judge the quality of care or even how likely you are to get pregnant yourself. As we know, infertility is a complex disease that requires complex solutions and even when the cause of infertility is known, treatment options can vary widely based. So how should you evaluate different fertility centers when choosing one for your care?
The gold standard of evaluation of the fertility center success rates lies in the data collected and analyzed by the Society of Assisted Reproductive Technology (SART). Every year they collect scores of data from fertility centers around the country, analyze it, and generate reports for consumers. Because this process takes a fair amount of time, the most recent report (which is still, as of this writing, considered preliminary) is from cycles completed in 2014.
When looking at the results for fertility centers you’re considering, the single most valuable data point to examine is the percentage of embryo transfers that result in live births. The reason this is the best statistic to examine is that it reflects a true, take-home-baby rate, as opposed to a pregnancy rate. What’s the difference? The live birth rate excludes pregnancies that result in miscarriage (or more uncommonly, stillborn), so it’s a much more accurate marker of success.
Also it’s important to keep in mind the age of the egg donor, particularly if you’re using a gestational carrier. If you’re using your own eggs for the IVF cycle, be sure to look at the statistics that match your age and not the age of your surrogate mother. Because of her medical history and previous successful pregnancies, her age should not figure prominently into the odds of success.
The SART report does come with one caveat that’s important to note – the reports do not account for medical history or health of the fertility centers’ patients. What this means is that theoretically, one clinic could have very tight standards for couples with whom they’re willing to undertake an IVF cycle. By excluding these more difficult cases, they’re treating women who are more likely to get pregnant, and this could artificially inflate their percentages of success.
One of the greatest benefits of the SART report is the way it’s organized – you can search by state and therefore compare the rates of fertility centers near you. And you may find some smaller centers that you didn’t know existed that could be a great match for you. This report allows you to get a head start of comparing the options, which is extremely valuable.
But don’t let the SART report guide your entire decision, even if one fertility center has an outstanding take-home-baby rate. It’s equally important that you see the office, meet the nurses and doctor(s), and get a good feeling about the operations. You will be spending a fair amount of time at the facility, not to mention a substantial amount of money, so it’s best to make a decision with the most amount of information possible.
The SART report is an excellent place to start, and you can find it here.