National reporting of in vitro fertilization success rates How do we get patients useful information

Capsule:
This editorial demonstrates the challenge in interpreting and communicating clear information to patients regarding the success rates of in vitro fertilization.

Authors:
Marcelle Cedars, M.D.

Volume 100, Issue 5, Pages 1210-1211, November 2013

Abstract:
This editorial demonstrates the challenge in interpreting and communicating clear information to patients regarding the success rates of in vitro fertilization.

  • Daniel Kenigsberg

    Dr Cedars’s many concerns about the completeness of reporting are all valid. However, the logical direction of this approach may lead to a report that is so complex that it does not accurately guide patients or practitioners. Some would contend that our current system already suffers from the same problem. How can an unguided consumer look at per stim, per retrieval, per transfer pregnancy or delivery data and make sense of it? The answer is they cannot without guidance. Whether the bottom line is birth (single or otherwise), number of attempts or cost, how the data applies to an individual patient is a pathway that requires a series of questions:
    Will I get to retrieval?
    Will I get to transfer?
    How many of each and for what cost?
    What is the likelyhood of a positive (and negative) outcome?
    The schemes for defeating this or any system have become a full time job for some and, given the generally high national outcomes of US IVF, unnecessary for the public good. SART needs to present clear simple data and the steps that lead into those numbers and percentages. To do less is confusing at best and dishonest at worst.

    • Marcelle Cedars

      Thank you for your thoughtful comments. Absolutely the system is already complex and the changes moving forward may at first appear complex. They will be somewhat more complex for the programs, but giving patients useable information is critical. What a patient knows is that she will start a cycle. And it certainly matters whether it requires 1 or 3 cycles to get to a transfer and potential for pregnancy. It will impact time, money and emotion for each trial. Also, having a standard “denominator”, for all reporting, will also make the inevitable comparisons that patients make with the data, more realistic.

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