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How to measure the success rate(s) of a fertility programme

This part of the site has been produced to provide doctors and couples contemplating fertility treatment with up to date information on the results of our assisted conception programme in order to provide them with realistic expectations of the likely treatment outcome.

We have a flexible treatment policy at TMC Fertility Centre, with couples being considered for treatment based on their individual merits. This may mean that, although couples may have been refused treatment at other centres they may be accepted for treatment at TMC Fertility Centre. We strongly believe that, if a well-informed couple feels that they have a reasonable chance of achieving a successful outcome they should be given the opportunity to try.

This site obviously deals with generalities. For each couple, at their consultation or during their treatment we provide an individual prognosis based on their particular condition and age.

In analysing pregnancy rates, one must look at the numerator versus the denominator. Numerators used are

• Total Pregnancy Rate
• Clinical Pregnancy Rate
• Delivery Rate (most centers also call this the "Live Birth rate")
• Number of Babies Born rate (some centers also call this the "Live Birth rate")

To avoid confusion, we present our figures using the Delivery rate and Number of Babies Born rate. "Total Pregnancies" include biochemical pregnancies i.e. pregnancies diagnosed on serum (blood test) but not seen on the ultrasound scan. As so-called biochemical pregnancies are often difficult to prove and never result in a delivery, it is best not to mention or include it in assessing the success rate of a fertility centre.

Clinical pregnancy is diagnosed when the pregnancy sac is seen on the ultrasound scan. Most clinical pregnancies will result in the delivery of a baby (babies). Most delivered yield a single baby while some would be twins, triplets or even more. For example, in an IVF Programme, the following could be used.

• Total Pregnancy Rate of 49.6%
• Clinical Pregnancy Rate of 47.3%
• Delivery Rate of 40.3%
• Number of Babies Born rate of 65.9%

Denominators used are

• Per cycle started
• Per cycle reached OPU (egg-pick-up)
• Per Embryo Transfer

Not all patients started on a cycle of IVF or ICSI will reach the stage where their follicles are aspirated (to obtain their eggs). Further, not all attempts at aspiration results in healthy fertilized embryos that can be transferred.

For example, in an IVF Programme

• 152 cycles are started
• 150 cycles reached egg pick-up (OPU)
• 129 cycles had embryo-transfer (ET)

Therefore it is obvious that using different numerators or denominators would change the Pregnancy Rate significantly. In comparing Pregnancy Rates, it is important to ensure that the same numerator and denominator are used.

In the above example,
Total Pregnancy rate / Number of ET = 49.6%.
However,
Number of deliveries / Number of ET = 40.3%

As the 129 Embryo Transfers yielded 52 Deliveries, resulting in 85 babies born, the Number of Babies Born / Number of ET = 65.9%
(NB : These figures are actual figures for TMC's 2001 IVF cases)\

Our IVF success rate (Comparison 2001-2003)
Our IVF success rate (2001)
Our ICSI success rate
Our FET (Frozen Embryo Transfer) success rate