The SART Clinic Summary Report (CSR) allows patients to view national and individual clinic IVF success rates. The data presented in this report should not be used for
comparing clinics. Clinics may have differences in patient selection and treatment approaches which may artificially inflate or lower pregnancy rates relative to another
clinic. Please discuss this with your doctor.
The outcome of a primary cycle for patients using their own eggs may be delayed if the retrieval occurred during the reporting year, but the outcome of the first embryo
transfer will not be known until the next reporting year. We are now accounting for treatment outcomes that are realized one year beyond the end of the reporting
year. Therefore the annual CSR will be labeled “preliminary” the first year it is posted and “final” the following year.
A cycle is counted when a woman has started medications for the purpose of having an ART procedure. In the case of a “natural” cycle when no medications are used, the cycle starts with the first day of a woman’s menstrual cycle when she is planning to have an ART procedure done that month. The cycle is counted if an egg retrieval is performed or if the cycle is cancelled before the egg retrieval. If several cycles are performed to bank eggs or embryos, each will be counted in the denominator when calculating the pregnancy rate. For example, if three successive ovarian stimulation cycles are performed with the purpose of accumulating or “banking” embryos for one embryo transfer later that year that results in a delivery, the delivery rate would be 1/3 (33%). We feel that counting each cycle and not just focusing on the embryo transfer more accurately reflects the treatment burden and costs the patient has endured.
In this report, we have emphasized the delivery of a child (rather than a positive pregnancy test) as the main outcome of interest, since this is the outcome patients desire. We also have emphasized singleton deliveries since twin and higher order multiple pregnancies have a higher risk of premature delivery and have increased medical complications during the pregnancy and after delivery, often with infants requiring stays in the neonatal intensive care unit. Cycle success is measured by the live birth rate with a singleton delivery occurring after 37 weeks of gestation being the optimal outcome of IVF cycle. The percentage of triplet, twin and singleton births contributing to the live birth rate are provided for each cycle group and a summation of all deliveries (singletons and multiple births) is provided in the report. We have also reported the risk of premature delivery by dividing the live births into three groups including delivery occurring before 32 weeks of gestation (very pre-term), 32-37 weeks of gestation (pre-term) or reaching term (>37 weeks).
Outcomes are divided by several factors including patient age and source of the eggs whether autologous (originating from the female patient) or donor eggs. These are important prognostic factors and by separating the data, you can get a better idea of both national and individual clinic experience by these factors. The report contains additional filters for infertility diagnosis, stimulation type and other treatment details are available for patients to review the number of procedures and outcomes for specific patient groups and treatments.
For women undergoing treatment with their own eggs, the end point of a treatment cycle can vary and this report attempts to capture the success rate following one or
more egg retrievals and the first embryo transfer (primary outcome
), the success of subsequent cycles
using frozen eggs or embryos not transferred in the first embryo
transfer and, finally, the combined contribution of the primary and subsequent cycles to the cumulative
live birth rate for a patient.
A cycle is initiated for egg retrieval. This cycle is concluded with the outcome of the first embryo transfer (fresh or frozen embryos) or it has been determined that embryo transfer will not be performed within a year of the egg retrieval cycle start. This endpoint is the PRIMARY OUTCOME.
If an embryo transfer occurred, the PRIMARY OUTCOME may be attributed to either a fresh or frozen embryo transfer. If you wish to review primary outcomes from fresh embryo transfers, use the FILTER feature and exclude frozen embryo transfers. If you wish to review primary outcomes from cycles where no fresh embryo transfer occurred and the outcome is from the 1st frozen embryo transfer, use the FILTER feature and include only frozen embryo transfers.
The subsequent cycle is any cycle involving the thawing of eggs or embryos after the PRIMARY OUTCOME has been determined. This is the cycle that is started either after the 1st embryo transfer has occurred or if more than one year has passed since the egg retrieval and this cycle is the first egg of embryo thaw. The endpoint is the SUBSEQUENT OUTCOME.
The cumulative live birth rate reflects the chance of achieving a live birth after a fresh or frozen embryo transfer within a year of cycle initiated for egg retrieval. The live birth may have been the PRIMARY OUTCOME (from the 1st fresh or frozen embryo transfer) or a SUBSEQUENT OUTCOME (frozen embryo transfers). The 2014 reporting year was the first year that subsequent cycles were linked to the egg retrieval cycles to generate the cumulative outcome or CUMULATIVE LIVE BIRTH RATE per egg retrieval cycle.
The live birth rate per patient includes the outcomes for patients who are new to an infertility center and starting their first cycle for retrieval of their own eggs during the reporting year.