Learn About Pregnancy Rates

The American Society of Reproductive Medicine is "Infertility's" self-governed body. The Society for Assisted Reproductive Technology is where fertility centers must report their statistics. Both societies state that any advertisements of comparative pregnancy rates include the following:

"As entry criteria are highly variable for each program, a center-by-center comparison of results is not valid."

As a patient, you are interested in selecting the right fertility center. We are a very experienced fertility center. We understand what you are looking for but we also understand how confusing and frustrating it can be. Although we have great statistics, we encourage you to look beyond statistics and costs to get a total assessment of which center you will trust with this important decision. The statistics may indicate the competence of a fertility center, but we regret to inform you that they may indicate something else. Please be careful.

The following provides you with insight to 5 ways in which a fertility center can increase their pregnancy rates without increasing the care provided:

The Right Type of Patient

Regarding patient selection, who are the right patients? They are young patients, with normal clomiphene challenge tests, with a previous pregnancy, no prior IVF or gonadotropin IUI failures, no prior pregnancy loss, short duration of unexplained infertility, known tubal blockage, low FSH values, and have a partner with normal sperm. These are just some of the criteria an initial consultation/screening process may include. From two different centers, a couple may hear two different responses:

a) "I'd only be taking your money." b) "Your chances are lower, but we are willing to help."

"Higher pregnancy rates" will then be used as a marketing tool to lure the right type of patients, while simultaneously provided difficult patients to the competing fertility center.

The Right Classification of Patient

There are two main ways to classify patients to improve pregnancy rates. The first is research. If a center has a difficult patient, that patient can be a reseCRM patient. The statistics from research patients are not reported.

The other method is to convert cycles mid-stimulation. If an IVF cycle stimulation does not look good, it can be converted to an IUI cycle and avoid reporting. Conversely, if an IUI cycle looks good, it can be "enhanced" as an IVF cycle and be reported. The patient may have gotten pregnant anyway.

There are proper times to convert cycles, it is the frequency of this occurrence that should be alarming.

The Right Type of Therapy

There are basically three types of advanced infertility therapy. They are gonadotropin IUI, IVF and donor IVF. Patients can be encouraged to accept a therapy that is beyond their current need. A patient likely to get pregnant on a simple Ovulation Induction cycle is even more likely to conceive with an IVF cycle. This drives IVF pregnancy rates up, and makes the choice between the two therapies even more distinct and confusing for future patients. The same holds true for IVF patients with somewhat questionable egg quality and the choice to pursue donor IVF.

The Right Time to Stop Therapy

There are two strategies to improve pregnancy rates regarding stopping therapy. The first is canceling a cycle mid-stimulation and thus avoiding the reporting requirement. Although canceling a cycle is sometimes necessary, it is important to know a fertility center's cancellation rate and how often IVF cycles are converted to Ovulation Induction cycles.

The second strategy is to encourage difficult patients to quit therapy. Although there is a time for this, typically the pregnancy rates stagnate after the fourth attempt. If a center can avoid the fifth attempt, their rates will not be compromised.

The Right Embryos

The chance of becoming pregnant increases with the number of embryos transferred. Therefore, some physicians are more aggressive, and often carry a higher multiple birth rate. (With the existence of selective reduction, it is important to know multiple rates before reductions.) Sometimes more embryos are encouraged to transfer because of their "poor quality". Sometimes this "poor quality" embryo discussion leads to another strategy.

Frozen cycle pregnancy rates are not as high as fresh cycles (or as expensive). Overall pregnancy rates improve with fewer cycles that are frozen embryo transfers. Therefore, there are subtle ways to discourage freezing embryos.

The Right Thing to Do

There are many other ways pregnancy rates can be improved. One can just look at a specific time period. We hope that you will look at all the factors that ultimately make up success. Our experience speaks for itself. We encourage you to speak to medical professionals about our character, philosophy and treatment. We are here to help.