‘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 firstname.lastname@example.org for details of the concierge support programme offered by the International Fertility Company.