New SART Reporting Sheds Light on the Meaning of Success
Whats Changed in the Reporting?
According to SART, transparency and clarity are underlying goals of the new reporting system.
Reflecting reality. Given many changes in how infertility is treated today, SART is striving to help patients better understand whats involved in success rates. Increases in embryo cryopreservation, comprehensive chromosome screening, and single embryo transfer are more adequately captured by the new reporting system.
In addition, the new report includes the number of IVF cycles as well as the delivery of a healthy child for an individual over time, including both fresh and frozen embryo transfers. According to SART, including all stimulation cycles more accurately reflects the real treatment burden and costs involved for each patient.
Redefining success. The report emphasizes delivery of a single child since this is the ultimate goal of prospective parents. The report highlights singleton deliveries in green. This emphasis is critical, given that multiples increase risks such as premature delivery and complications. In contrast, the old reporting system only reported overall pregnancy rates without separating out singleton pregnancies vs. twins or triplets. This provided incentive to providers and patients to transfer multiple embryos to achieve higher overall pregnancy rates, which arguably is not the best clinical practice.
In addition to breaking out data about singletons from that of multiples, SART now also breaks out the time of delivery into three groups: very pre-term, pre-term, and term. This is helpful information because delivering babies at term greatly increases the chances for a healthy baby. Again, the emphasis stems from the fact that singleton pregnancies are more likely to deliver at term, whereas twins and triplets are more likely to deliver pre-term and very pre-term.
Primary Outcome: Another major change is in the way primary outcome (successful pregnancy) is reported for women using their own eggs. The old system reports delivery rates in IVF cycles with fresh embryo transfers. However, modern IVF utilizes comprehensive chromosome screening to select healthy embryos. These embryos are frozen for future transfer. Primary Outcome will calculate delivery rates from the first embryo transfer (fresh or frozen) after an intended egg retrieval, which is more reflective of success in the first attempt at IVF.
Subsequent Outcome: Recognizing that multiple embryos can result from an egg retrieval and be cryopreserved, the Subsequent Outcome category reflects pregnancy rates from those frozen embryo transfers.
Cumulative Outcome per Intended Retrieval: This category is a major and long awaited addition to the reporting system. Cumulative Outcome calculates delivery rates from all embryo transfers (fresh PLUS frozen) using embryos that derive from the initial intended egg retrieval. This is a meaningful statistic because prospective patients want to know how likely they are to become pregnant from one complete cycle of treatment.
What the New Reporting Says about PFC
The biggest story revealed with the new reporting is our success with singletons delivered at term. At PFC, we have always focused on building families one healthy baby at a time. Our numbers are a clear reflection of this forward-thinking philosophy: In 2014, we had very low twin and triplet rates and low pre-term and very pre-term delivery rates, yet simultaneously maintained excellent delivery rates, which are shown in the below table compared to national average.
Our singleton live birth rates at PFC in 2014 were 8%-63% higher than the national average across all age groups in Cumulative Outcome and were equally impressive in the Subsequent Outcome category. Notably, twin rates at PFC were only a fraction of national rates. These data highlight our emphasis on transferring single high-quality embryos to achieve our goal of one healthy baby at a time.