Live birth is the correct outcome for clinical trials evaluating therapy for the infertile couple

Capsule:
Outcomes of clinical trials for fertility treatments are often ambiguous and confusing. The preferred outcome in infertility trials is live births per woman (or couple).

Author:
Kurt Barnhart, M.D., M.S.C.E.

Volume 101, Issue 5, Pages 1205–1208

Abstract:
Well-designed and -conducted clinical trials are needed to further advance the field for reproductive medicine. However, current reporting of outcomes of trials is ambiguous and disparate. In this review it is offered that the preferred outcome for clinical trials in reproductive medicine should be live birth. Multiple births should be listed, and it should be specified whether this is multiple births per couple or multiple births per conception. The unit of measure should be women (or couples) and not cycles. The duration of exposure should also be clearly identified (i.e., treatment was one cycle, a prespecified number of cycles, or a period of time). Pregnancy loss should be specified, and the denominator should be those who conceived. Although live birth is the primary outcome, complications should be defined and reported, including multiple births and other objective markers, such as preterm delivery, small-for-gestational age, or stillbirth.

  • Jason Kovac

    same point goes for male trials and outcomes from varicocele repair for example. It is however easier to focus on values that physicians have easier access to… like post-varicocele semen analysis. Obtaining pregnancy history is very difficult. given that the majority of “research” is retrospective chart reviews this will probably continue.

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