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General considerations:
Success rates cannot be simply quoted
and compared, and must be interpreted with caution.
They are affected greatly by the definition of
pregnancy, the stage of treatment reached on which
rates are based, and selective restriction of the
types of cases treated.
Some centers test for the pregnancy
hormone HCG even before the menstrual period
following treatment is delayed, and include such
“biochemical ” pregnancies in their results although
many will fail at a very early stage. We see no
point in such testing and include “clinical ”
pregnancies as confirmed by later ultrasound
scanning. Even so, the pregnancies can miscarry or
be ectopic (in the fallopian tube), and what really
matters is the chance of successfully having a baby,
which we give in our results as is now preferred
also by the Center for Disease Control (CDC's)
Reproductive Health Information Source.
Pregnancy rates are also often quoted
variously based on cycles of treatment started, or
cycles reaching attempted egg recovery, or cycles
reaching the stage of embryo transfer. Obviously the
pregnancy rates will increase accordingly due to
failures at earlier stages. If egg collection is
frequently cancelled because of suboptimal ovarian
response to stimulation, pregnancy rates will appear
higher (per egg collection) but at considerable
wasted cost and effort. We have a very low
cancellation rate -and rarely fail to collect an
egg. However, the results per egg collection can
also be calculated from the information given.
Refusal to treat unfavorable cases
such as women over 40 years or with other special
factors, as described earlier, obviously helps to
keep overall success rates up, but we make no such
restriction (provided the outlook is reasonable)
although of course advising couples accordingly of
their reduced chance of success.
Expectations of success:
Rarely is there absolutely no chance
of conceiving naturally. The choice of treatment
therefore depends on a balance of chances of
conceiving naturally (with or without relevant
treatment) or by assisted conception methods. The
woman’s age may be another pressing factor to opt
for assisted conception rather than less reliable
treatment. The chances of conceiving naturally by
conventional treatment should be discussed with the
physician.
¶
Success rates reported by positive pregnancy test as
pregnancies per embryo transfer for only one
treatment action. Additional successes with frozen
embryo transfers are not included in these
statistics. American Society for Reproductive
Medicine Practice Committee Report & Guidelines for
ART Programs: comparison of clinic success rates may
not be meaningful because patient medical
characteristics and treatment approaches vary from
clinic to clinic. Prior success rates should not be
construed as an indication of the likelihood of
success in an individual case
¥
Success rates reported as live births per oocyte
retrieval for only one treatment action. Additional
successes with frozen embryo transfers are not
included in these statistics. American Society for
Reproductive Medicine Practice Committee Report &
Guidelines for ART Programs: comparison of clinic
success rates may not be meaningful because patient
medical characteristics and treatment approaches
vary from clinic to clinic. Prior success rates
should not be construed as an indication of the
likelihood of success in an individual case.
