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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.
