For immediate release
June 5, 2017 (New York, NY) – National in vitro fertilization (IVF) clinic outcomes, annually reported by the Center for Disease Control (CDC) under congressional mandate, are misleading to the public, as some IVF clinics increasingly use “embryo banking” in many IVF cycles, a study in the medical journal Reproductive Biomedicine Online reports.
Under the current CDC reporting rules, “embryo banking” cycles are not counted by the CDC in the calculations of IVF success rates. Consequently, when performed especially in poorer prognosis patients, “embryo banking” disproportionately creates an opportunity to inflate IVF cycle success rates, since centers with high utilization of “embryo banking” can preferentially report those only for better prognosis patients who have higher live birth chances.
The study confirmed this suspicion: When investigators from New York City’s Center for Human Reproduction (CHR) assessed the proportion of “embryo banking” cycles for all reporting U.S. IVF centers, live birth rates per center increased in direct correlation with increasing utilization of “embryo banking.” When, however, outcomes reported to the CDC were statistically appropriately adjusted by including “embryo banking” cycles, live birth rates dramatically decreased with increasing utilization of “embryo banking.”
When 27 outlier clinics with the highest rate of “embryo banking” (above 40% of center cycles, representing 6% of all clinics), out of 458 reporting clinics, were separately investigated, they demonstrated higher live birth rates than the remaining 94% of clinics (33.1% vs. 31.1%) under CDC’s reporting rules. When live birth rates were calculated correctly by including “embryo banking” cycles, outcome comparisons reversed in dramatic fashion, with outlier clinics demonstrating significantly lower live birth rates (15.5% vs. 26.6%).
Indeed, the outlier clinics, which included some of the nation’s most prominent IVF centers, produced live birth rates below the median of the remaining 94% of national clinics. These 27 outlier clinics, nevertheless, proportionately held double the market share of annual U.S. IVF cycles. A misled public appears to reward those clinics for highly exaggerated outcomes. The authors of the study urge the CDC to revise their reporting system, a step the Society for Assisted Reproduction (SART), which maintains a voluntary parallel reporting system, already has initiated.
About Center for Human Reproduction (CHR)
Center for Human Reproduction (CHR) is a leading infertility clinical and research center of international renown, located in New York City, and serving a worldwide clientele. The two senior authors of the study, Vitaly A. Kushnir, MD, and Norbert Gleicher, MD, are available for further comments.