Success Rates

Adora Fertility has always been transparent about our success rates (and our costs) and so we welcomed the launch of the YourIVFSuccess website on 15th February 2021. www.yourivfsuccess.com.au

This initiative from the Federal Government is designed to give people needing fertility treatments an independent source of information about what IVF involves, general success rates and specific success rates for individual clinics around Australia.

IVF is a complex field of medicine and measuring success rates in IVF is also complex as there is not one single measure that gives a complete answer. Our view is that clinics should not “cherry-pick” and then publish the data that paints them in the most favourable light and we recommend to our patients to consult this website and take their time to go through it in detail. There is a lot of information but the brains behind this initiative have overall done a good job of trying to make things easy for people to understand and to be fair to all clinics in the way the data is reported.

What’s on the website?

The website has a section on what IVF involves and information about various treatment options. This is a useful starting point for anyone thinking they may need IVF to help them have a family.

IVF Success Estimator Tool

The website also has an IVF Success Estimator Tool which estimates your chance of having a baby through IVF (based on the national average of all the clinics). You put in some demographic data: age of female, age of male, cause of infertility etc and it will give you a chance of IVF success in that cycle and subsequent cycles. Research consistently shows that women and couples over-estimate their chances of IVF success, particularly for older patients, and this tool can be useful in giving a more realistic expectation of treatment success. It is, however, very important to bear in mind that this is averaged national data, that it is based on only a few variables and that it is data for couples that have a fertility issue. Please use this estimator tool as a guide only and bear in mind that your Fertility Specialist has years of training and expertise to adjust that success rate for you as an individual patient based on your specific history.

IVF Success Measures

The website also has a section on IVF Success Measures for individual clinics around Australia. As mentioned before, IVF success can be measured in different ways and this data is currently presented as four different measures, a further measure will be added later once the final data set comes through. If you would like further detailed information about each measure then click on each.

Success Rates by Clinic

Sydney

Births per complete egg retrieval cycle (including the later transfer of resulting embryos)

This shows live births per complete egg retrieval cycle for all patients having an IVF cycle and is broken down into age groups <35 and 35-42. It includes the fresh embryo transfer and any subsequent frozen embryo transfers from embryos created during that cycle (for a minimum of 1 year and maximum of 2 years after the initial cycle).

This is a very useful measure to look at and overall, along with measure 2, is the most fair assessment of a clinic’s success rate.

It would be more useful if the data was broken down into narrower age brackets. However, unlike Adora that does a large amount of IVF cycles every year, some clinics have small cycle volumes. If the data is broken down too much into specific age brackets the number of patients for some clinics in each age group would be too small to make the data meaningful.

Births per complete egg retrieval cycle (including the later transfer of resulting embryos) for women having their first ever egg retrieval.

This is the same as what is calculated for Measure 1 except that instead of using the data from all IVF patients it is only using the data for patients undertaking their first ever cycle of IVF.

This measure is used as the “equalising” measure as there are some clinics or clinicians that see a high proportion of patients who have had repeated IVF cycles without success or come from other clinics for a second opinion. Patients who have previously had unsuccessful IVF cycles will generally have lower success rates and this measure tries to correct for that.

Births per individual treatment attempt

This is the chance of a live birth per IVF attempt when an embryo transfer procedure was undertaken or planned. The embryo or embryos that were replaced may have been fresh (in the same cycle as the egg collection) or frozen-thawed (in a frozen cycle). Included in the statistics is when no eggs were collected (in fresh cycles) or the embryo did not survive the thawing process (in frozen cycles).

Births per embryo that is transferred

This shows the chance of a live birth from each individual fresh or frozen embryo that was transferred. The time point in the IVF cycle at which the denominator of this measure is calculated is at the time of embryo transfer, ie if there is no embryo to transfer it will not be captured at all by this metric. There are number of steps before an embryo transfer: collection of eggs, fertilisation of the eggs, growing the embryo to day 5 (gold standard) and transferring it or also freezing it and having it survive the freeze for a frozen transfer. This is why putting too much emphasis on this measure can be misleading as it may not take into account the other parts of IVF cycle and will be abnormally skewed if that embryo has been genetically tested.

Brisbane

Births per complete egg retrieval cycle (including the later transfer of resulting embryos)

This shows live births per complete egg retrieval cycle for all patients having an IVF cycle and is broken down into age groups <35 and 35-42. It includes the fresh embryo transfer and any subsequent frozen embryo transfers from embryos created during that cycle (for a minimum of 1 year and maximum of 2 years after the initial cycle).

This is a very useful measure to look at and overall, along with measure 2, is the most fair assessment of a clinic’s success rate.

It would be more useful if the data was broken down into narrower age brackets. However, unlike Adora that does a large amount of IVF cycles every year, some clinics have small cycle volumes. If the data is broken down too much into specific age brackets the number of patients for some clinics in each age group would be too small to make the data meaningful.

Births per complete egg retrieval cycle (including the later transfer of resulting embryos) for women having their first ever egg retrieval.

This is the same as what is calculated for Measure 1 except that instead of using the data from all IVF patients it is only using the data for patients undertaking their first ever cycle of IVF.

This measure is used as the “equalising” measure as there are some clinics or clinicians that see a high proportion of patients who have had repeated IVF cycles without success or come from other clinics for a second opinion. Patients who have previously had unsuccessful IVF cycles will generally have lower success rates and this measure tries to correct for that.

Births per individual treatment attempt

This is the chance of a live birth per IVF attempt when an embryo transfer procedure was undertaken or planned. The embryo or embryos that were replaced may have been fresh (in the same cycle as the egg collection) or frozen-thawed (in a frozen cycle). Included in the statistics is when no eggs were collected (in fresh cycles) or the embryo did not survive the thawing process (in frozen cycles).

Births per embryo that is transferred

This shows the chance of a live birth from each individual fresh or frozen embryo that was transferred. The time point in the IVF cycle at which the denominator of this measure is calculated is at the time of embryo transfer, ie if there is no embryo to transfer it will not be captured at all by this metric. There are number of steps before an embryo transfer: collection of eggs, fertilisation of the eggs, growing the embryo to day 5 (gold standard) and transferring it or also freezing it and having it survive the freeze for a frozen transfer. This is why putting too much emphasis on this measure can be misleading as it may not take into account the other parts of IVF cycle and will be abnormally skewed if that embryo has been genetically tested.

Melbourne

Births per complete egg retrieval cycle (including the later transfer of resulting embryos)

This shows live births per complete egg retrieval cycle for all patients having an IVF cycle and is broken down into age groups <35 and 35-42. It includes the fresh embryo transfer and any subsequent frozen embryo transfers from embryos created during that cycle (for a minimum of 1 year and maximum of 2 years after the initial cycle).

This is a very useful measure to look at and overall, along with measure 2, is the most fair assessment of a clinic’s success rate.

It would be more useful if the data was broken down into narrower age brackets. However, unlike Adora that does a large amount of IVF cycles every year, some clinics have small cycle volumes. If the data is broken down too much into specific age brackets the number of patients for some clinics in each age group would be too small to make the data meaningful.

Births per complete egg retrieval cycle (including the later transfer of resulting embryos) for women having their first ever egg retrieval.

This is the same as what is calculated for Measure 1 except that instead of using the data from all IVF patients it is only using the data for patients undertaking their first ever cycle of IVF.

This measure is used as the “equalising” measure as there are some clinics or clinicians that see a high proportion of patients who have had repeated IVF cycles without success or come from other clinics for a second opinion. Patients who have previously had unsuccessful IVF cycles will generally have lower success rates and this measure tries to correct for that.

Births per individual treatment attempt

This is the chance of a live birth per IVF attempt when an embryo transfer procedure was undertaken or planned. The embryo or embryos that were replaced may have been fresh (in the same cycle as the egg collection) or frozen-thawed (in a frozen cycle). Included in the statistics is when no eggs were collected (in fresh cycles) or the embryo did not survive the thawing process (in frozen cycles).

Births per embryo that is transferred

This shows the chance of a live birth from each individual fresh or frozen embryo that was transferred. The time point in the IVF cycle at which the denominator of this measure is calculated is at the time of embryo transfer, ie if there is no embryo to transfer it will not be captured at all by this metric. There are number of steps before an embryo transfer: collection of eggs, fertilisation of the eggs, growing the embryo to day 5 (gold standard) and transferring it or also freezing it and having it survive the freeze for a frozen transfer. This is why putting too much emphasis on this measure can be misleading as it may not take into account the other parts of IVF cycle and will be abnormally skewed if that embryo has been genetically tested.

Important things to bear in mind

Adora encourages patients to use this website but echoes the point made by ANZSREI (the peak Australian body representing CREIs, the official college recognised fertility qualification for doctors in Australia and New Zealand) that states:
“When patients are choosing fertility clinics or if they have had unsuccessful cycles, ANZSREI Executive does not recommend solely using the YourIVFsuccess website in their decision. Instead we recommend patients are aware of the current limitations of the website and consider other aspects such as patient centred care, cost and importantly the experience and qualifications of their doctor.”

When comparing Adora to other clinics we hope that you will be pleased to see that we align well with National Averages. This is why we do what we do. Our doctors, nurses, scientists and admin staff are absolutely committed to providing quality fertility care at a cost that is accessible and affordable for all Australians.

When it comes to success rate measures, Adora Fertility does have 2 distinct disadvantages in how these measures are calculated compared to some other clinics and we hope you bear this in mind as you are not always comparing “apples with apples”.

Firstly, Adora Fertility does not currently have access to donor sperm, it is not covered under Medicare. Donor sperm cycles are included in the measures and given that the majority of cycles involving donor sperm are in women that do not have an underlying fertility issue that is due to a medical reason (ie single women and same sex couples) it is misleading to include this data in the success rates measures.

Secondly, Adora Fertility does not currently undertake genetic testing of embryos for their chromosome status (PGT-A). This is because it is not covered by Medicare and it has never been convincingly shown to increase pregnancy rates overall, in fact, it may harm them. The 4th Measure (Births per Embryo Transfer) will be elevated for embryos that are genetically tested and are shown to be normal. But remember, in order to appear in this metric the embryo has to be available to transfer because the time point at which the measure is calculated is from the point of embryo transfer. If there is no embryo to transfer it does not appear in this metric. Remember in order for the genetically tested embryo to be at the point of transfer (and thus included in this metric) it needed to survive the biopsy, be frozen, survive the thaw and be genetically normal so it is no wonder that some PGT-A tested embryos have very high pregnancy rates.

In summary, we welcome the YourIVFSuccess website and encourage our patients to explore it in detail. However, we also highlight that there are some limitations to the website and encourage patients to speak directly with their Fertility Specialist at Adora Fertility to receive an honest and realistic appraisal of their own unique situation.

Dr Paul Atkinson
National Medical Director Adora Fertility
B Sc MBBS M Rep Med FRANZCOG CREI

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