Reporting in vitro fertilization cycles to the Society for Assisted Reproductive Technology database: where have all the cycles gone?

Clinics with significantly higher rates of nonreportable in vitro fertilization cycles present higher live birth rates compared with all other clinics in the United States.

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Authors

David Kulak, M.D., Sangita K. Jindal, Ph.D., Cheongeun Oh, Ph.D., Sara S. Morelli, M.D., Scott Kratka, B.S., Peter G. McGovern, M.D.

Volume 105, Issue 4, Pages 927-931

Abstract

Objective:

To assess the relationship between live birth rates (LBRs) and the incidence of under-reported cycles by IVF clinics.

Design:

Cohort study.

Setting:

Not applicable.

Patient(s):

All patients undergoing IVF cycles in the aforementioned clinics.

Intervention(s):

Not applicable.

Main Outcome Measure(s):

The reporting percentage (RP), defined as number of cycles with reported pregnancy rates divided by total cycles performed. Results from cryopreservation cycles are only presented by SART if an embryo transfer occurs. Thus, RP decreases as incidence of embryo or oocyte banking cycles increases. The LBRs in women aged <35 years were compared between clinics. Result(s):

The median RP of all clinics was 93%–97%. Clinics with RP <80% increased from 2 in 2004 to 30 in 2012. Twenty-one clinics had an RP that fell 2 standard deviations below the mean in any year. Over the 9 years, there was a negative correlation between RP and LBR of −0.17, but for the 21 outlier clinics the correlation increased to −0.26. In 2012 alone, in outlier clinics, for every 10% drop in RP there was an associated rise in LBR of 4.3%; some clinics reported 40% fewer cycles than the median. Conclusion(s):

In clinics with very low RP, the cycles that are reported have higher success rates. Regardless of intent, the reduction of reported data to SART makes it increasingly difficult for clinicians and patients to accurately assess a clinic’s success rates.

Read the full text at: http://www.fertstert.org/article/S0015-0282(15)02308-0/fulltext

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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