Embryo Transfer Clinics - A Critical Look

     In December, 2001, an update was published to the earlier reports on IVF clinic success rates. The 2001 update was based on data compiled through the end of 1999. What follows is a summary of that update. The most dramatic difference between the 1997 study (based on 1995 data) and the 2001 study is that the success rates (i.e., live birth rates per embryo transfer procedure) have increased significantly. Whereas national success rates in 1995 averaged 25%, in 2001 they increased to 31.3%. In other words, clinics across the board performed 25% better in 1999 than they did 4 years earlier. Plus, the "adverse outcome" rate (i.e., miscarriage, stillbirths, etc.) dropped from 22% in 1995 to 17.5% in 1999, meaning not only were women more likely to become pregnant, but they were more likely to sustain the pregnancy. And, success rates among older women (>35) similarly increased. A 40 year old woman, for example, had a live birth rate in 1995 of about 14%. In 1999, that rate jumped to 22%, a 50% increase.
     
      Some statistics remained constant. Generally, it was still true that success rates increased as the number of embryos transferred increased (up to three). Transferring more than 3 embryos actually decreased success rates. Also, the size of the clinic had some, though not a significant effect on success rates. The largest clinics in the country (those doing more than 225 cycles annually) had success rates only slightly higher than the smallest (those clinics performing less than 50 transfers annually). Plus, success rates using fresh embryos still were significantly higher than with frozen embryos (31.3 % vs. 17.6%), as was the case 4 years ago. Lastly, success rates using donor eggs were almost always higher, and in some cases significantly higher, depending on the age of the donor, as compared to using one's own eggs.
     
      In 1999, there were about 66,000 cycles started. About 20,000 resulted in pregnancies, and 16,500 resulted in live births. In 1999, there were 821 embryo transfer cycles involving surrogates. The live birth rate was about 30%. What is most striking about these new results is that the number of clinics having the best success rates has increased dramatically. In 1995, of those facilities using surrogates, only one clinic in the country had a success rate over 50%. 9 others had success rates of 40-50%. In 1999, 4 clinics had success rates over 60%, and 25 had success rates of 50% or higher!
     
      The table that follows lists these "best" clinics in the country. Those with asterisks next to their names were also among the best in 1995. As before, these statistics should be viewed with caution. One would expect that many facilities today have increased their success rates as well. Plus, I have taken the completely arbitrary figure of 50% success rates to designate the "best" clinics. You should always contact any clinic, ask them what their current live birth rate is, their costs, and their protocols. The complete study is available at http://www.cdc.gov/nccdphp/drh/art.htm, or it can be obtained in hard copy from the CDC at (770) 488-5200.

Listing of the "Best" Embryo Transfer Clinics in USA