In Vitro Fertilization (IVF) Success Rates
As every year, we are offering CHR’s preliminary IVF cycle outcomes as early as possible. Because due to COVID-19 cycle numbers in 2020 were lower than in prior years, we are this year a few weeks ahead of schedule. Click here to see our 2018 outcomes in SART’s Snap Shot report.
Here are a few reminders that must be considered in correctly interpreting the data:
- CHR serves the oldest patient population of any U.S. IVF center, reporting fresh non-donor cycles to national registries at CDC and SART (and likely in the whole world). The pie chart confirms this fact by demonstrating that 85% of fresh non-donor cycles occurred in women above age 40. Indeed, almost half (48%) occurred in women above age 43 and 37% in women above age 44 including some cycles in women in their 50s.
- Even women under age 40, however, in almost all cases presented with low functional ovarian reserve (LFOR) and, therefore, despite their younger ages, were relatively poor prognosis patients. While age can be compared with other IVF centers in national registries, and we, therefore, can make a categorical statement about the age of CHR’s patients, LFOR cannot be objectively compared. Our believe that CHR also serves the overall most unfavorably selected patient population among all U.S. IVF centers (and likely the world) is, therefore, only our subjective, though well-grounded, opinion.
Age of women undergoing non-donor autologous IVF cycles
As we always point in presenting last year’s data so early in the following year, live birth rates, as of this point, are noy yet determined. Those, at the earliest will be known in approximately one year. This is the reason why national registries report cycle outcome always with 2-3 years delays. What we here report, are clinical pregnancies, defined as pregnancies with fetal heart seen on ultrasound. They can be assumed to be close to the live birth rate since pregnancy losses after fetal heart are rare; but live birth rates are always somewhat lower than clinical pregnancy rates. ASRM requires from its membership (and CHR is a member) to point out this fact when reporting pregnancy rates and not live birth rates.
- Equally important, here reported pregnancy rates are reported with reference point embryo transfer and not with reference point cycle start (intent to treat), as CHR usually strongly recommends. The reason for this is the age of CHR’s IVF patients. With almost half of all patients over age 43, many patients never reach embryo transfer because their cycles are either cancelled, no eggs are retrieved, or no embryos are available for transfer. In as poor a prognosis population as CHR is treating, reporting with reference point cycle start, therefore, makes little sense: Patients at those ages who initiate IVF cycles with their own eggs fully understand their risk of obtaining no eggs/embryos. They are, however, interested in knowing what their chances of success may be if they at least produce one embryo for transfer. Obviously, chances increase with increasing numbers of embryos available for transfer. ASRM also mandates that these facts be disclosed when reporting outcomes not per “intent to treat.” Moreover, ASRM in such situations also mandates establishment of a link to the SART registry where CHR’s earlier live birth rates by “intent to treat” are listed. As noted earlier, these outcomes are, however, always 2-3 years removed.
Clinical Pregnancy Rates
|Age||Fresh Autologous Cycles with Embryo Transfer||Autologous Frozen-Thawed Cycles||Third Party Egg Donor Cycles|
|< 30||33.3%||34.0%||Fresh Donor Cycle||57.1%|
|36-39||25.0%||Gender Selection||Frozen Donor Eggs||20.0%|
|40||14.8%||16.7%||Frozen Donor Embryos||40.5%|
|42||14.3%||Frozen-Thawed Cycles after PGT-A|
|43||17.7%||Chromosomal "abnormal" embryos||70.0%|
|44+||0%||Chromosomal "normal" embryos||50.0%|
Considering our center’s patient population, above summarized cycle outcomes must be viewed as exceptional. They, indeed, would have to be considered as excellent even at an IVF center that serves an average patient population. To achieve such outcomes in what clearly represents the oldest but, likely, also the most adversely selected patient population at any IVF center in the U.S (and likely the world) must, indeed, be viewed as exceptional.
Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.