Assisted reproductive technology practice patterns and the impact of embryo transfer guidelines in the United States

Objective [1] To evaluate trends in number of embryos transferred and resultant high-order multiple (HOM) pregnancy rates by Society for Assisted Reproductive Technology (SART)-member clinics between 1996 and 2003 and [2] to relate these practice patterns and outcomes to clinic compliance with SART–...

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Bibliographic Details
Published in:Fertility and sterility 2007-08, Vol.88 (2), p.275-282
Main Authors: Stern, Judy E., Ph.D, Cedars, Marcelle I., M.D, Jain, Tarun, M.D, Klein, Nancy A., M.D, Beaird, C. Martin, Grainger, David A., M.D., M.P.H, Gibbons, William E., M.D
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Cell Count
Embryo Transfer - trends
Female
Guideline Adherence
Gynecology. Andrology. Obstetrics
Humans
Internal Medicine
IVF
Maternal Age
Medical sciences
multiple pregnancy
Obstetrics and Gynecology
Practice Guidelines as Topic
Practice Patterns, Physicians' - trends
Pregnancy
Pregnancy Rate
Pregnancy, Multiple
Reproductive Techniques, Assisted - trends
Retrospective Studies
SART-ASRM guidelines
success rate
United States
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Summary:Objective [1] To evaluate trends in number of embryos transferred and resultant high-order multiple (HOM) pregnancy rates by Society for Assisted Reproductive Technology (SART)-member clinics between 1996 and 2003 and [2] to relate these practice patterns and outcomes to clinic compliance with SART–American Society for Reproductive Medicine (ASRM) embryo transfer guidelines. Design Retrospective. Setting Society for Assisted Reproductive Technology–member fertility centers in the United States. Patient(s) Five hundred thirty-six thousand, five hundred twenty-four fresh, nondonor IVF cycles. Intervention(s) None. Main Outcome Measure(s) Number of embryos transferred; pregnancy rates; implantation rates; and proportion of singleton, twin, and HOM pregnancies. Result(s) The number of embryos transferred declined each year. High-order multiple pregnancy rates also declined, whereas the twin rates remained stable. The most pronounced declines in number transferred occurred immediately after publication of SART-ASRM embryo transfer guidelines. After stratifying clinics according to mean and modal number of embryos transferred, clinics transferring the fewest embryos in women
ISSN:0015-0282
1556-5653
DOI:10.1016/j.fertnstert.2006.09.016