How to interpret success rates
Many factors contribute to the success of an ART procedure. Some of them are related to the experience of the ART professionals and the quality of services they provide. Other factors are related to the patients themselves, such as their age and the cause of their infertility. At Gynera we treat all patients, including difficult cases and those who have been unsuccessful elsewhere.
Success rates depend on many factors:
- Age of the female partner (the most significant factor)
- Conditions contributing to infertility
- Quality of eggs and number of eggs recovered
- Quality of sperm (including motility and ability to penetrate the egg)
- Type of ART (Fresh / Frozen, IVF / ICSI)
- IVF lab quality
- Skill and competence of the treatment team
Success rates for IVF procedures vary considerably by the clinic. Some programs give a much higher chance for success than others. When interpreting success rates, there are some factors to consider:
Definition of Pregnancy
Pregnancy might be defined as evidence on ultrasound scan or just a positive blood test.
Definition of Pregnancy Rate
Pregnancy rates might be reported as:
Percentage of ART cycles started that produced a pregnancy
Percentage of embryo transfers that produced a pregnancy
Percentage of ART cycles started that resulted in a live birth
Calculation of success rates per cycle or per patient
Some clinics include pregnancies from frozen cycles in the original stimulated cycle successrate.
Other clinics calculate success rate per patient, cumulating the results from three or more attempts.
Number and characteristics of the cycles performed
Clinics that perform few cycles have not a statistically significant success rate.
Percentage of patients with difficult infertility problems
Some clinics accepts many difficult cases with low probability of success.
The number of embryos transferred
Some clinics transfer more embryos, attempting to increase the pregnancy rate.
The Gynera Fertility Center discourages the transfer of a large number of embryos because it increases the likelihood of multiple gestations.
Europe and U.S. success rates
The most recent European IVF-monitoring (EIM) report presents the results of assisted reproductive techniques in Europe during 2007. Data on 493 184 reported ART cycles have been collected from 33 European countries by the European Society of Human Reproduction and Embryology (ESHRE). The data collected are large enough to represent the vast majority of important clinics and to offer a significant reference when assessing the success rate:
Europe 2007 (ESHRE IVF-monitoring, www.eshre.eu)
Average pregnancy rate per embryo transfer:
Fresh nondonor IVF cycles 32.8 %
Fresh nondonor ICSI cycles 33.2 %
Frozen embryo transfers 22.1 %
Egg donation cycles 46.2 %
Multiple delivery rate: 21.7 %
Complications rate per cycle: Ovarian hyperstimulation syndrome (OHSS) 0.5 %
Delivery rate for IUI:
Woman age < 40 > 40
IUI-H 10.2 % 6.3 %
IUI-D 14.6 % 6.1 %
The most recent United States IVF-monitoring for 2008 have been published online by U.S. Department of Health and Human Services, Centers for Disease Control (CDC) at “http://www.cdc.gov/ART/ART2008”
Age of the female partner has a significant impact on success rate and risk of complications. The U.S. registry provides detailed data on these aspects.
U.S. 2008 (CDC online publication)
Average pregnancy rate per embryo transfer:
|Woman age||< 35||35-37||38-40||41-42||43-44|
|Fresh nondonor cycles||55 %||46 %||38 %||27 %||15 %|
|Multiple pregnancy rate:||39 %|
|Pregnancy loss rate:||19 %|
(including miscarriages, stillbirths or maternal deaths prior to birth)
The Gynera Fertility Center results for the first two years are presented, as they have been reported to the romanian registry authority, the National Agency for Transplant.
We are proud of having outstanding results with a lot of difficult cases (aging, testicular biopsy cases). Our preliminary results position us among the most successful centers in the world.
ART can be stressful, frustrating, expensive and time-consuming. But it has allowed many couples to have children that otherwise would not have been conceived.
|In 2008 we reported the firsts pregnancies in our country from vitrified blastocysts. Since then, the number of pregnancies from frozen cycles continues to grow.
IUI cycles 2011 210
Many couples with low chances insist to do a lot of IUI cycles, because they cannot afford or accept IVF. This contributes to a low rate of success for IUI with husband sperm. With correct indication and with donor sperm, the results of IUI are excellent.