Loopholes in federally mandated IVF outcome reporting lead some IVF clinics to artificially inflate IVF pregnancy rates, study reports

For immediate release

June 14, 2013 (New York, NY) - A small number (13) of IVF centers manipulate federally mandated reporting of IVF outcomes by artificially inflating their clinics' pregnancy rates, thus gaining economic advantages over properly reporting centers, a new study reports in Fertility & Sterility, the official medical journal of the American Society for Reproductive Medicine (ASRM).1

Under the Fertility Clinic Success Rate and Certification Act of Congress (FCSRCA) of 1992, IVF centers are required to report IVF cycle outcomes, including IVF pregnancy rates, annually to the Centers for Disease Control and Prevention (CDC). Many centers report their outcome data to CDC through reports to the Society for Assisted Reproductive Technologies (SART), a daughter society of the ASRM, which maintains a voluntary national reporting system in parallel. Both outcome data sets are publicly available, and, despite representations from CDC and SART that comparisons between clinics based on these data can be misleading, patients often rely on these outcome data when selecting IVF centers.

The study, published by investigators from New York's Center for Human Reproduction, evaluated the integrity of the national reporting system by focusing on how many IVF cycles individual clinics excluded from formal reporting. Using standard statistical methods to define outliers, the study found that only 13 out of 341 clinics (3.7%) represented 50% of all non-reported cycles. These 13 clinics failed to report outcomes for 37.3% of IVF cycles started at their centers. Further analysis demonstrated that a majority of non-reported cycles involved older women, who are expected to have lower pregnancy chances. The 13 clinics reported significantly higher pregnancy rates than all other clinics, and over the 5-year study period between 2005 and 2010 increased their share of the U.S. IVF market by as much as 19%.

"In essence, we found that 13 out of 341 analyzed IVF centers artificially inflated their pregnancy rates and, likely as a consequence, expanded their market share," explains the study's lead author, Vitaly A. Kushnir, MD, attending physician and assistant scientist at the Center for Human Reproduction (CHR), New York. Dr. Kushnir also serves as consultant to the CDC's Reproductive Health Division, which publishes the Annual Clinic Reports, mandated by Congress.

"We conceived of this study because Senator Wyden, who was instrumental as Congressman in passage of the FCSRCA, recently suggested this national IVF reporting to CDC as a 'good example' for other reporting systems that could be implemented throughout medicine under the Affordable Care Act," adds Norbert Gleicher, MD, the study's senior author and Medical Director and Chief Scientist at CHR. Dr. Gleicher continues: "Our results, of course, suggest otherwise."

1Kushnir VA, Vidali A, Barad DH, Gleicher N. The status of public reporting of clinical outcomes in assisted reproductive technology. Fertil Steril 2013 [Epub ahead of print].

About Center for Human Reproduction
The Center for Human Reproduction (CHR), located in New York City, is one of the world's leading clinical fertility and research centers. Drs. Kushnir and Gleicher are available for further comments.

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