Understanding the National SART Report and 2014 Success Rates

SART Data blogThe 2014 SART clinic specific IVF success rates have now been released on the Society for Assisted Reproductive Technology website, and 2014 was another strong year for RSC. 2015 IVF success rates will not be reported until the spring of 2017.

SART reports for IVF centers are becoming more and more complicated for patients to understand. Make sure that if you are comparing different IVF clinics, you compare “apples to apples,” meaning look at the same category of outcomes across clinics.

SART data breakdown

Preliminary Cumulative Outcome per Intended Egg Retrieval – This category includes your chance of achieving a live birth from one IVF cycle begun using your own eggs, and includes transfers derived from fresh and frozen embryos from that one stimulation cycle.

Preliminary Primary Outcome per Egg Retrieval – This means your chance of delivering a baby from the first embryo transfer (whether a fresh or frozen transfer) using your own eggs from one stimulation cycle. This includes patients whose first transfer is a fresh transfer from the stimulation cycle, as well as patients who have had all their embryos frozen from the stimulation cycle (for Pre implantation Genetic Screening (PGS) and other reasons) and their first embryo transfer from the stimulation cycle is a frozen transfer.

In this category, you can also click on drop down for “show cycle characteristics” and you will be able to view:

  • The average number of embryos transferred in each age group
  • The percent of ESETs (Elective Single Embryo Transfers) the clinic does
  • The implantation rate for age groups in that center (see discussion below).

Preliminary Subsequent Outcome – This means the chance of achieving a live birth using your own eggs from the second embryo transfer from one stimulation cycle – this is a frozen embryo transfer and may be the first or second frozen embryo transfer. If the stimulation cycle was a freeze all cycle (PGS) this would then be the second frozen embryo transfer cycle.

Preliminary Live Birth per Patient – This means the chance you have for a live birth using your own eggs from your first IVF cycle in our center. It does not count patients going through their second or third cycle in our center. Patients going through their second or third cycle may have a lower IVF success rate.

Fresh Donor Eggs – Your chance of delivering a baby if you do a fresh embryo transfer using donor eggs. This category includes all ages of women using donor eggs, most of them over 40 years of age.

Frozen Donor Eggs – Defined as your chance of delivering a baby if you use frozen donor eggs (not embryos), for example from an egg bank.

Donor Eggs – Thawed Embryos – This is your chance to deliver a baby using frozen embryos from an egg donor. This category usually includes patients who have not gotten pregnant from a fresh egg donor cycle.

Donated Embryos – your chance of delivering a baby if you use embryos donated from another patient.

Implantation rates are important

Most experts in the infertility field think that Implantation Rates are the most important statistic that reflects how well a lab/IVF program is performing. This rate can be found by clicking on the “show pregnancy outcomes” button in categories of Preliminary Primary Outcome per Egg Retrieval and Preliminary Subsequent Outcome (Frozen cycles).

Implantation rate equals the number of embryos that stick or implant in the uterus divided by the total number of embryos transferred. If the implantation rate is high this means the IVF Lab is culturing/growing the embryos well, and the doctors are stimulating the patients and prepping the uterine lining well.

Implantation rate may be the best way to compare programs IVF success rates. If one center transfers more embryos, they may have better pregnancy and live birth rates, but the efficiency/quality of embryos produced, cultured and transferred in that center is not as good as another program with similar pregnancy and live birth rates that transfers fewer embryos.

Centers transferring more embryos will often leave their patients with more high-risk pregnancies due to multiple pregnancies. Having high implantation rates allows good centers to transfer fewer embryos having excellent pregnancy rates but fewer high-risk multiple pregnancies.
RSC has had very high implantation rates for a number of years.

Elective single embryo transfer (eSET)

At RSC a very high percent of transfers in women under < 37 are single embryo transfers (eSETs) (significantly higher than the national average of eSETs for IVF centers), reducing the number of high risk twin pregnancies, and having more embryos to freeze for future pregnancy attempts.

RSC continues to deliver outstanding pregnancy and delivery rates with donor egg — significantly higher than the national average. Our implantation rate in donor egg cycles is very high because a high percentage of those cycles are ESETs.

Does SART report PGS data?

Preimplantation Genetic Screening of embryos (PGS, sometimes called CCS) pregnancy rates are very hard to obtain from the 2014 SART report. This is because the SART category of Preliminary Primary Outcome from Egg Retrieval includes the first embryo transfer after an egg retrieval whether it is a fresh embryo transfer or a frozen embryo transfer.

Many of the frozen embryo transfers in this category are from PGS cycles. Approximately 30 percent of RSC IVF cycles were PGS cycles in 2014. RSC has a huge amount of experience and success with PGS. More than 40 percent of our IVF cycles were PGS cycles (>400 PGS cycles) in 2015.

PGS allows older patients to have higher pregnancy rates per transfer by screening the embryos to make sure they are genetically normal before transferring them. If PGS is not done, the most common reason for IVF to fail is the transfer of genetically abnormal embryos in older women.

RSC has delivery rates that are significantly higher (often 10 percent or more) than the national average in almost every category in the 2014 SART clinic specific report. These highlights are meant to help patients understand what data should be important to you in reading the SART Clinic reports.

 

The Reproductive Science Center of the Bay Area is a leading pioneer in infertility treatments including IVF with egg donation and LGBTQ family building. We’ll work with you to help you achieve your dreams of having a baby.

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