Evaluating and Comparing Program Statistics
The following information regarding an IVF program should be considered:
1. Are there parameters, such as age or FSH level that exclude patients from participation in the program?
For example, a program that excludes all patients above a certain age and/or with decreased ovarian reserved (borderline or elevated FSH) may have better statistics and lower cycle cancellation rates than a program which accepts even the most difficult cases. At Penn Fertility Care, the success rates are among the highest in the region, even though we do not have a strict inclusion policy and we do not have exclusion criteria for consultation.
2. What is the mean number of embryos transferred per fresh IVF cycle and what is the high order multiple pregnancy rates (triplets or more)?
Responsible programs should try to maximize their pregnancy rates while minimizing the high order multiple pregnancy rates. For example, does a particular program transfer more embryos to achieve a similar or, sometimes, even lower pregnancy rate? This may indicate sub-optimal laboratory conditions, or a less refined embryo transfer technique, which usually results in lower viability rates for the embryos. Painstaking laboratory quality control and continuous updating of procedures as advances in the science of IVF occur are key in improving a program's success.
It should be pointed out that studies have clearly shown that increasing the numbers of embryos transferred to greater than 3 does not substantially increase the pregnancy rates, but increases the high probability of multiple pregnancy rates. At Penn Fertility Care, we have consistently transferred the fewest number of embryos in the region and among the fewest in the country, while maintaining high pregnancy rates and very low high order multiple pregnancy rates.
3. What are the frozen embryo pregnancy/delivery rates and what are the guidelines for freezing embryos?
This is key to an outstanding program and goes hand in hand with the goals of improving success rates while minimizing the high order multiple pregnancy rates. There is no question that as pregnancy rates from fresh embryo transfers have improved, attention should be drawn to improving procedures for freezing and thawing embryos in order to maximize the number of pregnancies a couple can achieve from a single egg retrieval. In addition, increased pregnancy rates from frozen embryo transfers are an indirect indication of high–quality laboratory and transfer procedures. At Penn Fertility Care, success rates from frozen embryo transfers are amongst the highest in the region and in the country.
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