How to Evaluate an IVF Program
The quality and services of an in-vitro fertilization program
is of paramount importance to patients with infertility. It is
very easy to compare one make of an automobile with another by
reading several consumer reports that compare multiple parameters
amongst the different manufacturers and a reasonable conclusion
can be made before even test driving the car. The evaluation of
an in-vitro fertilization program is more difficult. Unfortunately,
few standards exist to compare in-vitro fertilization programs.
National reporting of clinic-specific pregnancy rates has led
consumers to use these numbers to assess quality. But is this
reasonable? High pregnancy rates per cycle come at a price. The
price takes the form of excluding less than ideal candidates,
accepting higher order multiple pregnancies by transferring more
embryos, excessive numbers of cases of ovarian hyperstimulation,
and recommending in-vitro fertilization to patients who would
otherwise conceive with simpler approaches.
In-vitro fertilization programs vying for the highest pregnancy
rates regardless of other factors are under pressure to exclude
patients who have a less than ideal prognosis with in-vitro fertilization.
This would include patients greater than 35 years of age, FSH
levels greater than 9, patients who smoke, patients with only
one ovary, and patients with severe male factor infertility.
Centers who also seek the highest pregnancy rates regardless
of the consequences have a tendency to transfer a larger number
of embryos and, accordingly, accept higher order multiple pregnancies.
To an infertile couple this may seem acceptable, however, multiple
pregnancies result in a higher risk of both maternal and fetal
complications. Multiple births born to women at any age are high
risk births with twins being 4 times, triplets 10 times and quadruplets
13 times more likely than singletons to die within the first month
of life.
Southeastern Fertility Center is Dedicated to You!
At Southeastern Fertility Center our product is a service to
help infertile couples manage their infertility disorder. We do
this by adhering to the highest ethical standards, educating our
patients about their disorder and recommending the most cost effective
treatment. We strongly believe that any patient with a reasonable
chance at pregnancy should be allowed infertility treatment. Sometimes
we are successful and sometimes we fail, but quality for us is
a satisfied patient who understands their condition and its treatment,
and feels that the best advice was given and the treatment, if
indicated, was attempted with the best possible medical supervision
and service.
The Southeastern Fertility Center in-vitro fertilization program
is based upon the latest ovarian stimulation protocols using a
combination of both recombinant gonadotropins and human menopausal
gonadotropins to optimize both egg and endometrial development.
The ovarian stimulation protocols are individualized based upon
patient age, FSH level, prior in-vitro fertilization history,
and a variety of other factors. Our embryology lab uses the latest
sequential media with incubation in low oxygen tensions to enhance
blastocyst formation and pregnancy rates.
To minimize the number of embryos transferred and maximize pregnancy
rates we commonly perform embryo transfers on the fifth day after
egg retrieval, which is referred to as the blastocyst stage. This
stage of embryo growth allows us to select those embryos with
the best morphological features, thus allowing us to transfer
only the embryos that would result in the highest pregnancy rates.
By transferring a smaller number of blastocyst embryos we are
able to maintain our high clinical pregnancy rates while minimizing
the high order multiple pregnancies.
In a continuing effort to improve our in-vitro fertilization
center, the physicians and staff frequently attend national and
international conferences to present research and review the latest
in-vitro fertilization techniques. We participate in both internal
and external audits of our in-vitro fertilization program to obtain
independent evaluations, second opinions and advice.
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