CHR's Year To Date pregnancy rate represents ongoing clinical pregnancies that were signed out into Ob-care. A comparison of clinical success rates may not be meaningful because patient medical characteristics and treatment approaches may vary from clinic to clinic.The listed pregnancy outcomes reflect ongoing clinical pregnancy rates and not delivered pregnancies. The pregnancy rates are calculated as a percentage of embryo transferred, and not as a percentage per cycles started. Delivered pregnancy rates will be somewhat lower than clinical pregnancy rates and percentages, based on numbers of cycles started, will be lower than rates based on the numbers of egg retrieval performed.

We are now presenting pregnancy outcomes in smaller age groupings because in excess of 85% of cycles, performed at CHR-NY in 2006, were in women with diminished ovarian reserve, either due to advanced female age or in women with prematurely aging ovaries.

CHR-NY, Clinical Pregnancy Rate/Per Transfer including all IVF cycles at CHR
(January, 2007 to December, 2007)

* The patients in these age groups in our practice almost uniformly suffer from prematurely aging ovaries (POA) and often were elsewhere referred into egg donation before consulting with CHR.

Comments to 2007 Statistics Listed Above

The here quoted pregnancy rates are 2007 results and do not necessarily reflect on future performance. Since patient populations vary between fertility centers, the here presented outcome data should not be used for comparisons between different centers. This is best demonstrated by the exceedingly high prevalence of women with premature ovarian aging (POA) and, therefore, diminished ovarian reserve, in CHR patients, as recently reported in detail (Barad et al. Obstet Gynecol 2007;109:1404-10).

Considering the very unfavorable patient population at CHR, 2007 pregnancy rates, therefore, have to be considered excellent. Because outcomes above age 40 can change from year to year, they are presented in 1-year age groups. This, however, results in relatively small patient numbers and outcome percentages should, therefore, be viewed with caution.

CHR-NY, Clinical Pregnancy Rate/Per Transfer and restricted only to
IVF cycles with comcomitant preimplantation genetic diagnosis (PGD)
(January, 2007 to December, 2007)

Comments to 2007 Statistics Listed Above

The comments noted above in reference to all IVF cycles also apply here. Special emphasis should, however, be given to the fact that most patients undergoing PGD do not have fertility problems. Their pregnancy rates should, therefore, in most cases be expected to exceed those of regular infertility patients. Considering the comparatively small number of PGD cases, the outcome percentages reported here should, however, be interpreted with caution.

The Future

We are, of course, very exited about our 2007 outcome data. This, however, does not mean that we intend to sit on our laurels. Very much to the contrary; As already noted above, as of 2007 we have expanded the utilization of DHEA to all women above age 40. We fully expect further improvements in our outcomes in older women, following this change. Our goal for 2008 is a first pregnancy in a 46-year old (or older) woman. This is currently the holy grail of infertility care. We have also introduced further individualization in stimulation protocols for the most resistant women to stimulation who, even after DHEA supplementation, do not respond. Considering the unfavorable characteristics of most of our patients, we can not expect much improvement in our frozen/thawed pregnancy rates, but we certainly will try. It is also difficult to expect improvements in oocyte donation cycles, when two third of patients conceive. But here, too, we will, of course, try to improve even further.

Most importantly, CHR will continue to drive knowledge forward. By further expanding our clinical research during 2008, we are convinced that we will continue to improve patient care results and our patients are always the first to benefit.