Volume 112, Issue 6, Pages 1013–1014
Richard J. Paulson, M.D., M.S.
It is now 34 years since Michael Soules, former president of the American Society for Reproductive Medicine, authored an editorial, “The in vitro fertilization pregnancy rate: let’s be honest with one another” (1). In it he decried the, at that time, common practice of inflating in vitro fertilization (IVF) pregnancy rates by reporting biochemical pregnancy rates, pregnancy rates per embryo transfer (and not per retrieval) and other methods of obfuscating the true, low, pregnancy rates. He challenged IVF investigators and practitioners to be honest with one another about the actual success rates of the still new and evolving technique of IVF, far more imperfect than what we have today. His editorial had a profound influence on me. It stood in stark contrast to reports of ever higher pregnancy rates reported in the lay media and in peer-reviewed publications, which seemed, even at that time, to be frankly too good to be true. It was as though the culture of IVF practice tolerated a high degree of exaggeration of success, and Soules’ editorial challenged that culture.