My mother was a teacher and instilled in me a deep-rooted commitment to educate and help others, which I suppose explains my military service as well as my professional calling as a reproductive endocrinologist for more than 20 years. I see hopeful parents every day at Reproductive Medicine Associates of New Jersey from Newcastle, England to New York City who can't get or stay pregnant. They face a lot of ups and downs in the pursuit of pregnancy. Throughout the process, they face a myriad of choices that can impact their time in care, money spent, as well as their chance of having a healthy baby -- the true measure of success in our field.
One of the first choices that all patients have to make is where to seek infertility care. It's a critical decision as practice patterns, treatment strategies, and technology used can vary greatly from one practice to another. Believe it or not, doctors specializing in infertility are one of the the only medical specialists I'm aware of that are required by law to report success rates and other data to the Centers for Disease Control and Prevention (CDC) and those results are made public--creating an invaluable resource for patients.
Each year, the Society for Assisted Reproductive Technology (SART) helps hundreds of thousands of Americans make choosing a center easier by releasing the success rates for every single fertility center across the U.S. The current SART report can be found by visiting www.sart.org. There are nearly 500 in vitro fertilization (IVF) programs and more than 1,000 reproductive endocrinologists in the U.S. that report valuable and accurate information that patients should review with a healthcare provider when choosing infertility care.
Earlier this year, SART released the latest nationwide data that includes results from a new reporting structure developed to increase clarity and transparency for patients. There's a lot of data provided broken out by age, treatment type, and by a number of other criteria. It might be confusing, so it's best to review this data with a physician or nurse. At our program, we are proud to report a delivery rate of 63.2% in women under 35 years of age (n=886) which is well above the national average.
SART is not the only resource--patients must also be their own advocates and be sure they ask the right questions when meeting with physicians. As the fellowship director at RMANJ, I'm always telling my fellows, "asking better questions gets you better answers." Here's just a couple of important questions that can help patients get the "better answers" they need to overcome infertility in the shortest time possible:
- Has the center reported IVF delivery rates consistently at or above the national average?
- Does the center routinely perform embryo transfers at the blastocyst stage (Day 5) of development?
- Does the center promote pregnancy rates or the more honest and transparent delivery rates?
- Does the center routinely perform genetic screening of embryos using validated technologies like Comprehensive Chromosome Screening (CCS)?
- Does the center account for endometrial synchronization (transferring embryos based on the receptivity of the uterus) during time of embryo transfer?
- Does the center provide care to couples with complex problems or do they use prior screening results to determine treatment eligibility?