This is a multibillion-dollar industry, and there is financial pressure for clinics to claim frequent success. "Clinics are competing with each other based on pregnancy and live birthrates," said Dr. Vitaly Kushnir, a reproductive endocrinologist in New York who researches success rates. The clinics do not want give out negative data that might drive away patients.
Nationally, the data suggest that a 38- to 40-year-old woman using her own unfrozen eggs has on average a 21.6 percent chance per cycle of having a baby by means of assisted reproductive technology. The average treatment cost per cycle rings in at $12,400, according to the American Society for Reproductive Medicine.
A cycle, which can take on average from 60 to 90 days from the time of the initial consultation, typically starts with hormone injections, followed by egg retrieval, fertilization and then embryo transfer. But the national success rate does not distinguish between pregnancies occurring in the first cycle or a second, fifth or later cycle. The number of cycles needed to achieve a successful pregnancy makes a big difference to would-be parents in terms of money, time and emotional strain.
The clinics also are not required to report babies born full-term or not, or those born with birth defects. "The outcome data should be included to reflect the most important goals and measures of success in I.V.F. — a healthy baby and healthy mother," said Dr. Kushnir. Moreover, success rates at individual clinics may vary widely, depending in part on the populations they serve. Some clinics have been known to turn away women who may be difficult cases — older women or those with existing medical conditions, for example — to avoid depressing their success rates.
To potential patients browsing online, it may not be clear how these clinics define success. "Someone might think the success rate is the number of live births, when really the clinic is reporting the number of clinical pregnancies," said Jim Hawkins, a law professor at the University of Houston who has studied the claims made on the websites of fertility clinics.
Dr. Kushnir and other researchers have pushed for more public information on the health of babies and mother after I.V.F. At the moment, potential patients can check reported success rates online, with the Society for Assisted Reproductive Technologies and the C.D.C., which separates the data by pregnancy and live births.
Image: Pregnancy test, via Shutterstock