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A question that only recently seemed to have gained popularity is, what does it mean if an IVF center reports high miscarriage rates? The honest answer is not very much! The principal reason why that mere fact, alone, does not mean very much is because high miscarriage rates may be, simply, based on the kind of patient population a center serves. For example, if a center serves older women than most other IVF centers, that center will encounter more miscarriages because miscarriages go up with female age. Or, if a center serves many patients with hyperactive immune systems, they, too, will have more miscarriages, as will women with congenital uterine abnormalities, etc. And how about centers that specialize in treating couples with repeated miscarriages? They, of course, also will demonstrate unusually high miscarriage numbers.
One, therefore, must be very careful in automatically attributing high miscarriage rates to something an IVF center does poorly. Yet, that, of course, is also a possibility!
So, how is a lay person then to know? The answer is through research on the IVF center: Does the center specialize in certain patients or does it serve an average patient population? What do other patients say about the center? How does your gynecologist feel about that center? And, if all of this, still, does not allow you to reach a judgment, ask the physicians at the center directly why their miscarriage rates are that high. You will then quickly be able to sense whether the answer makes sense, A well-run fertility center should know its own outcomes. If the physician is surprised that you know the center’s miscarriage rates or if she/he seems surprised by the numbers, that could be viewed as a warning sign.
What all of this once more demonstrates is how important it is to understand what a center’s strongpoints and, possible weaknesses are. All IVF centers are not the same. There are often huge differences in how centers approach the same infertility problems. Patients, therefore, should be selective as to where they choose to receive fertility services, especially if they have somewhat unusual underlying causes for their infertility. So, for example, if the problem is repeated pregnancy loss (habitual abortions), patients are well advised to seek out a center that has shown special interest in this problem and treats many patients with the problem. But don’t make high miscarriage rates, necessarily, the decisive issue in choosing a fertility center.
Norbert Gleicher, MD, FACOG, FACS
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.
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