‘There are three kinds of lies: lies, damned lies, and statistics’ is a term often used in discussions questioning the validity of any form of statistics. In the fertility world, the most used (and sometimes, abused) statistics are those that relate to the success rates of IVF treatment.

I am asked everyday without fail, ‘can I trust the success rates quoted by a fertility clinic’? The answer is important. Success rates are generally perceived as being the one of the most important drivers for patients when they choose the IVF clinic that will take responsibility for their fertility journey. Read the 2020 Fertility Travel Survey for more information about the reasons why patients choose particular clinics and countries to receive treatment.  

I will get to my answer a little later but first let us look at some of the ways in which treatment outcomes are recorded,

A Pregnancy Rate refers to those women who record a positive pregnancy test after an IVF cycle.

A clinical pregnancy rate refers to those women who exhibit evidence of pregnancy when the foetus can be either seen or heard.   

A live birth rate refers to the number of women who go on to have a live birth delivery.

Statistics which demonstrate these outcomes are calculated by dividing them by the number of IVF procedures performed which could mean the number of treatment cycles undertaken or embryo transfers. Some clinics report on cumulative pregnancy rates, that is, when the results refer to a number of recurrent cycles rather than a single one and you can begin to see how many variables are involved in calculating and reporting success!

In addition to the way that success rates are presented you will have to remember that their very basis is subject to a number of factors which can influence success. Let us consider three,

Firstly, we all know that fertility declines with age so when you consider the success rates of a particular clinic take a look at the age distribution of patients treated. Some clinics may not offer treatments to women of advanced maternal age, preferring to treat younger women with a greater chance of success. In this case, higher success rates will be reported. It is advisable therefore to consider success rates by age in order to get a more accurate measure of the clinic’s ability.

Another factor that can influence success rates is the number of embryos transferred in each cycle. Although it is now standard practice for the vast majority of IVF clinics to only offer single embryo transfers there are still those which offer patients multi-transfers which can determine success. Check with your potential provider to see what their transfer policies are and remember that although transferring multi-embryos might have higher success rates in terms of clinical pregnancy rates there are a number of negative outcomes associated with the procedure like miscarriages for instance.  

If we take the example of a woman of advanced maternal age, the chances of conception increase when she has IVF treatment with donor eggs. It is important therefore to try to identify the type of treatment which quoted success rates refer to. If you are choosing a treatment using your own eggs you will want to know the success rate for this!   

So, if we return to the initial question, ‘can I trust the success rates quoted by a fertility clinic’? what is my answer?

Well, with the exception of a very few unscrupulous clinics I have visited in my dozen or so years of visiting clinics across the world, I would say there is a basis of truth in the success rates that are quoted by the vast majority of externally regulated IVF clinics. I use the term, ‘basis of truth’ cautiously; we all know statistics can be created, interpreted and applied in different ways, and many clinics do this very effectively.

So, my short answer is that you can place a certain amount of trust in what you are being told. However, you should remember that the figures quoted are average ones and may not take into account your age, general and fertility health and the treatment you are seeking. To get a more bespoke figure of how successful your treatment might be in a clinic you need to seek an answer from staff which takes this specific information into account. And then, only then, can you be satisfied that the success rates you are being quoted are realistic for your particular case.

We are surrounded by IVF treatment providers that claim to provide personalised patient centred care and bespoke treatments Therefore, it is your right as patients who are in the centre of the treatment process to demand individual assessments regarding the chances of success and be given access to transparent, accurate and relevant success rates.

 If you would help in navigating your fertility journey, contact pamela@internationalfertilitycompany.com for details of the concierge support programme offered by the International Fertility Company.

As a former fertility patient, I know only too well how difficult it can be having to accept that you need treatment. On reflection, that is the easy part. After acceptance comes consideration and twenty years ago when my partner and I had to consider our options we knew nothing about those opportunities that sat further than a radius of ten miles outside our home, let alone those sitting in different countries.

Fast forward twenty years and how things have changed. Fertility patients literally have the world at their fingertips. From our living rooms we can order home test kits; send samples safely, undergo nurse and medical consultations, access virtual clinics and only really need to leave the room physically for the ‘business’ end of the journey, namely the egg retrieval and embryo transfer.

Would this have made things much easier for my partner and I? You would assume so, and in many ways, I think it would. Certainly, I would have appreciated doing a home sperm test rather than hurrying through rush hour traffic to hand over the sample at my local hospital and it would have been great to have had those difficult conversations from my armchair.

Then, unlike now, three major things were missing. We didn’t have the sophisticated internet we have now, and relatively few clinics had an online presence. Secondly, we didn’t have access to support. Just type ‘fertility support’ into any search engine today and you can access support for every conceivable need you might have. Thirdly, and as a direct result of the first two, we didn’t really have choice. For us, this meant our local NHS hospital after a private consultation, undertaken by the same consultant, only with the clock ticking.

Today, fertility patients have access to each of these things in abundance. Surely, that makes things so much easier.

Well, firstly, who do you trust? Do all clinics provide treatments with success rates ‘well above average’ and do all provide a ‘personalised’ service like no other? Marketing makes the world go around, and although reading between the lines takes some time, it is time you should spend.

The number of support platforms has ballooned over the last decade. With their roots in the philanthropic field where support came free, they have grown into a significant business opportunity for some. Fortunately, there are good ones out there, many created from personal experience, but you do have to be careful to select the ‘wheat from the chaff’, as my mother used to say.

Finally, Fertility patients now have choice. The world seems to be getting smaller and we now view travel as a way of accessing and addressing our medical needs as well as our leisure needs. Despite the best efforts of Covid-19, we are free to travel once more and this has enabled fertility patients to consider many different paths, offered by different providers in different countries. But once again, with literally thousands of options, which is the one for you?

The fertility journey for my partner and I is over but for all of you coming behind us, there are plus points, you finally have choice albeit with certain caveats. Choose wisely and the majority of you, I am sure, will have a successful end to your journey just like ours.

I have recently chosen to work with the talented, modest and very capable Eddie Kuan (The Fertility Medication Centre, Mediserve Clinic) to help set up Donor International to act as a trusted gatekeeper for those offering and requiring donor treatment. We are using our combined knowledge and networks of international treatment providers to offer patients access to the best, and for the providers themselves, we provide an opportunity to showcase the services they offer.

I hope the new platform will make donor identification and access easier, will allow the best clinics and banks to share availability and ensure that wherever you may travel, and whatever treatment you decide upon, it will be based on the transparent and qualified information which is offered by  Donor International.

Contact andrew@internationalfertilitycompany.com for more information about Donor International.

Many assisted reproductions clinics have a waiting list for their patients who need donor eggs for their IVF treatments. Generally, there is a shortage of donors, especially for certain phenotypes and ethnic groups. In some cases, intended parents have reported waiting up to two years to begin egg donation treatments, which is frustrating for clinics and patients alike. If we consider that many women needing to use donor eggs are already in their 40s, and that 50 is a general limit for IVF procedures in many countries, these waiting lists can actually mean that many women risk not having the chance of becoming mothers at all.

The good news is that egg banks, such as Ovobank ID, mean that these waiting lists can be avoided, allowing easier access to donor egg IVF, and at more affordable prices. In this article, we highlight how egg banks can put an end to waiting lists and open up availability and access to donor eggs in the following ways:

• A large number of available donors of varied ethnicities and phenotypes.
• Donor testing and screening performed before the donor profile is listed.
• Donor stimulation cycles, egg retrieval and egg freezing already performed.
• No need for synchronization of donor and recipient cycles.
• Online ordering and shipment of donor eggs to the fertility clinic.

USING A FROZEN EGG BANK MEANS MORE DONORS

A large egg bank, such as Ovobank ID, has hundreds of batches of frozen donor eggs from hundreds of different donors. Donors are recruited from various strategic locations worldwide, to be able to provide clinics with the diversity needed for their patients. A data base of donor profiles can be searched by the clinic and intended parents, with a wide variety of different ethnicities, races and phenotypes. Information on the donors, their lifestyle and likes, and photos of the donor as an adult and a child (where provided) can be viewed online to help in selecting the right donor.

PRE-SCREENED AND PRE-TESTED DONORS

Egg donors have many different reasons for wanting to donate some of their eggs. Many of these generous young women are mothers themselves, and wish to give other women the same opportunity of having a baby. When they make the decision to donate, they are subjected to extensive physical, psychological and gynaecological testing, as well as genetic screening, to minimize the risks of passing on any diseases to babies born using their eggs.

Only about a third of potential donors meet the strict criteria and become egg donors. When you see a donor profile on the Ovobank ID donor database, these tests have already been performed and you do not need to wait for the screening process.

NO WAITING FOR THE DONOR STIMULATION CYCLE

When you select from the frozen oocytes in stock, (in storage in liquid nitrogen), they are already ready to be transferred to the shipping containers to be sent to your clinic. The donor stimulation cycle (carefully tailored to each donor to respect their health) and the egg retrieval have already been carried out by our gynaecologists and specialist doctors. Our embryologists then take over to select the mature oocytes from the follicular fluid, perform the vitrification process and store them safely and securely in tanks of liquid nitrogen at -196°C, preserving their reproductive function.

 In contrast, if using fresh donor eggs, this process can be lengthy, as it needs to coordinate with the donor’s lifestyle and availability. With fresh donation there is always the risk that very few or low quality eggs are obtained, or even a cancelled cycle resulting in no eggs. This not only represents time spent with no progress, but also expense. Using frozen donor eggs is way to avoid these risks.

EGG DONATION TREATMENTS AT THE CONVENIENCE OF THE INTENDED PARENT

 When using frozen donor oocytes, there is no need to synchronize the recipient cycle with that of the donor. The intended parents can choose to undergo treatment at their convenience. The recipient only needs to have endometrial preparation, and the eggs thawed and fertilized in a coordinated fashion, so that the embryo(s) will be ready for transfer at the optimum moment of endometrial receptivity. At Ovobank ID we support our collaborating clinics with advice and protocols for the egg thawing and endometrial preparation, so that the best results can be achieved with our frozen eggs.

With a fresh donor cycle, all this needs to happen in a synchronized fashion with the donor. To find the right moment for both the donor to undergo stimulation and the recipient to undergo treatment may mean a considerable wait, and also adds to the risk of cycles being cancelled.

 EASY ORDERING AND FAST SHIPPING TO YOUR FERTILITY CENTRE

Patients and clinics can have access to hundreds of donor profiles to find their ideal match, and we also have a team of dedicated specialists to help, as well as Ovomatch, a biometric facial recognition app, to aid finding the donor that most physically resembles the mother-to-be. Once the donor is selected, and the batch size chosen, the eggs can be prepared for safe shipment to the centre where the treatment will take place. Shipping is quick, safe and secure, using Ovobank ID custom designed boxes to protect the precious cargo, and Ovotracker software to monitor the location and condition of the shipment.

Depending on the donor you choose and the location of your clinic, your order of frozen donor eggs could be with you within two weeks*: speeding up donor egg IVF treatments and ending the waiting lists for intended parents to start their family using donor conception.

 *some restrictions apply depending on country of origin, please enquire for details.

For more information, contact andrew@internationalfertilitycompany.com