Sunday, March 21, 2021

IVF success rate - Clinic success rate vs patient’s individual success rate


The IVF success rate seems to be such a simple number to calculate – after all, how hard can it be to determine the chances of a patient getting pregnant ?

 While it’s easy enough to calculate the success rate for an IVF clinic ( the number of babies/ number of IVF cycles done), the problem is that most IVF clinics in India fudge these figures and lie about them. They quote an extremely high pregnancy rate – and this is a number they make up, because they aren’t accountable or answerable, and it’s impossible for the patient to verify this, so they can and do get away with making all kinds of all claims.

The bigger problem is it’s much harder to calculate the success rate for individual patients !

This is because each patient does more than one cycle, and they care about their cumulative pregnancy rate. For them, it doesn’t matter much if they get pregnant in the first cycle or the third cycle, as long as they have a baby to take home !

The truth is that patients don't really care about the clinic’s overall success rate – they only care about their personal success rate. Now it’s easy to determine this after the IVF cycle is complete, because after the success rate is either 100% or 0% for the individual patient .

However, patients want the doctor to predict what the success rate is going to be before they start the IVF cycle, and this can be extremely hard ! Each IVF cycle gives us valuable prognostic information, which we can't obtain by any other test.

For one thing , our technology is not good enough to be able to provide accurate predictive figures for the individual patient , because of the law of small numbers. The outcomes of individual IVF cycles are too uncertain because of the multiple complex biological variable involved.

Another big issue is that doctors often make up these numbers . Because they want the patient to take treatment with them , they will quote all kinds of ridiculous figures , and there is no way of the patient finding out whether what the doctor is saying makes sense or not . Because the patient so desperately wants to get pregnant , they are willing to accept at face value everything the doctor says for them . Many patients naively believe that the higher the number the doctor quotes, the better the doctor ! This ignorance comes back to haunt them later on , when the cycle fails .

Finally, remember that as a patient, you should focus on the cumulative success rate – the chances of getting pregnant in 3 embryo transfers. In clinics like ours which do only a single blastocyst transfer, and freeze all the spare embryos, you can do 3-4 embryo transfers after doing only one egg collection – which means your overall success rate is much higher, as compared to a doctor who puts all your embryos back in the fresh cycle, because if this fails, you have no further embryos to transfer, and need to start a fresh cycle all over again.

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