Where is the Transparency in IVF Outcomes When Navigating Infertility?

An infertility diagnosis is often an emotionally and physically challenging experience for an individual or couple, and we recognize the immense disappointment that may follow. Fortunately, advancements in reproductive medicine have transformed the landscape of fertility treatments, offering hope to countless people aspiring to start a family. Among these innovations, In Vitro Fertilization (IVF) is a beacon of possibility, providing a pathway to parenthood for those facing infertility challenges. However, the journey from the initial stages of treatment to the ultimate goal of a healthy baby can be complex and often nuanced, influenced by a multitude of factors.

IVF success rates serve as a critical metric for patients and clinicians alike, offering insights into the effectiveness of various treatment protocols and the likelihood of achieving a successful pregnancy. Unfortunately, there are still no standardized measures of clinical success that are both reported and independently verified, making it very difficult to assess the quality of care delivered at individual clinics and nearly impossible to compare clinics.

Therefore, prospective patients often default to reading online reviews and soliciting recommendations from friends and family members. This can provide a great understanding of the patient experience at a given clinic, and is often helpful, but it doesn’t solve for understanding your individual likelihood of a successful outcome.

Age and Antral Follicle Count

While age is the single most important factor for determining egg quality, a patient’s antral follicle count (AFC) also serves as the crucial parameter in the assessment of ovarian reserve and is critical to consider when understanding your individual treatment plan and likelihood of success with IVF.

After an initial consultation with your fertility doctor, they should be able to give you a range or mature eggs that you can expect to retrieve during an IVF cycle, and roughly how many embryos that translates to. Each center will counsel slightly differently based on the success rates in their specific embryology lab. Great IVF centers are focused on incremental improvements throughout each stage of the process: from stimulation to retrieval to fertilization to blastocyst development, all with the end goal of maximizing your chances for a healthy pregnancy.

Remember that not every 35 year old or 40 year old will have the same chances based on their own unique physiology. Patients need information to understand their particular prognosis at each specific center, including how many mature eggs are expected to retrieve per cycle, and the prognosis for each usable egg based on the clinic’s historical lab outcomes.

Embryology Lab Metrics that Matter

When REI doctors want to understand “how good” a lab or IVF center is, in terms of their success rates, there are a few important metrics that they ask one another. These include:

1.  Day 6 Blastocyst Development Rate: the probability that a fertilized egg develops to a blastocyst embryo by Day 6.

Why is this important? This is a good metric to understand the strength of the physicians at managing protocols to ensure strong egg quality, as well as how adept the embryology lab is at fertilization and maintaining the best possible environment to culture embryos. Top centers will know this rate by age group (rate declines with age), but understanding this rate for female patients <35 will give a good baseline.

2.  Live Birth Rate for Single Frozen Euploid (Chromosomally Normal) Embryo: the probability of having a baby from a genetically tested embryo

Why is this important? This number helps a patient to understand not only how effective a clinic is at performing a Frozen Embryo Transfer, but also gives insight into how effective the embryology lab is at thawing and biopsying embryos. *Make sure this rate takes into account all embryos thawed, not just those transferred.

*For patients freezing eggs, there is an even greater lack of published data to inform likelihood of success. We recommend patients considering egg cryopreservation to ask their clinic for: 1) frozen egg survival rate, and 2) fertilization and blastocyst development rate for thawed eggs by age.

The Future of Reporting Outcomes

Transparency regarding clinical outcomes is paramount in empowering patients to make informed decisions about their care. Access to accurate and comprehensive data allows individuals to assess their chances of success realistically and explore alternative options when necessary. In recent years, efforts to enhance transparency and accountability within the fertility industry have gained momentum, with organizations advocating for standardized reporting practices, independent third-party verification of results, and greater visibility into clinic performance.

As advancements in reproductive medicine continue to evolve, so too will our understanding of fertility treatment outcomes. By fostering transparency, promoting patient advocacy, and embracing evidence-based practices, we can strive to optimize the chances of success and support individuals and couples on their path to parenthood.