CHR's Year To Date pregnancy rate represents ongoing clinical pregnancies that were signed out into Ob-care. We are especially proud to report that, following many years of clinical pregnancy rates over 60%, we in 2009 established a new outcome record of 66.7% clinical pregnancy rate from transfer of no more than 2 embryos. Considering that practically almost all egg donor cycles result in more than two embryos, this means that most patients end up with additional cryopreserved embryos, which, of course, represent additional pregnancy chances.

We must point out that a comparison of clinical success rates may not be meaningful because patient medical characteristics and treatment approaches may vary from clinic to clinic. The listed pregnancy outcomes reflect ongoing clinical pregnancy rates and not delivered pregnancies. The pregnancy rates are calculated as a percentage of embryos transferred, and not as a percentage per cycles started. Delivered pregnancy rates will be somewhat lower than clinical pregnancy rates; and percentages, based on numbers of cycles started, will be lower than rates based on the numbers of egg retrieval performed.

The tables listed below summarize clinical pregnancy rates in the various CHR IVF categories for 2009. Live Birth Rates are, of course, not yet available and will be reported via CDC/ASRM-SART early 2011.

NOTES
¹The IVF pregnancy numbers presented here would be considered excellent in any IVF program. What makes them, however, remarkable, almost astonishing, is the patient population in which they were achieved. CHR does not serve the traditional patient population of most IVF centers. As we reported in detail in the Fall 2009 CHR Voice, the center’s patient population has not only dramatically aged since 2006 (from mean ca. 36.0 to 39.5 years), but concomitantly our patients’ ovarian reserve (OR) has dramatically deteriorated, most extremely in women ages 31-35 years, where mean AMH levels plunged between 2008 and 2009 from almost 6.0 to almost 2.0 ng/mL.

In practical terms, this means that our Center’s youngest patients, up to age 35 years, are not the “usual” young patients with normal OR but to a great degree suffer from diminished ovarian reserve (DOR). Indeed, a large majority of these younger patients suffer from premature ovarian aging (POA) and come to our center after having failed IVF cycles elsewhere and, not infrequently, being advised to go into egg donation. Considering this very adversely selected patient population, the here reported combined pregnancy rate of 40.0% in women up to, and including, age 35 years is nothing but astounding!

The same considerations, of course, also apply to our patients above age 35 years, where OR parameters since 2006 have deteriorated to similar degrees, especially above age 40. Once again, we do not deal with average 40 and 41 year olds (average pregnancy rate for these two years 20.9%) or average 42 and 43 year olds (average pregnancy rate for these two years 12.2%). Most of these older women do not only suffer from advanced age but, on top of it, also have been prematurely aging their ovaries and, therefore, demonstrate even less OR than they should, based on their already advanced age. Indeed, in this age group, almost two-thirds reach us for first consultation after having been told that they no longer have a reasonable chance with use of their own eggs and their only remaining option is egg donation. The here reported clinical pregnancy rates in these patients speak for themselves!

The most interesting group may, however, actually be here reported patients above age 44 (up to almost 50 years) because these are patients who are refused treatment at practically all other IVF programs. Not surprisingly, their pregnancy rates are low (3.8%), but considering the age of these women and their OR status, quite miraculous. A pregnancy chance that low is, of course, not offered lightly. Patients with such low pregnancy chances receive very detailed informed consent before entering treatment. Very often this involves women who just “want to try once” with use of their own eggs before proceeding to egg donation. In our opinion, they deserve this chance to know that they “at least tried,” and 3.8% will win the lottery in addition.

²Per retrieval.

ECO-IVF CYCLES¹

NOTES
¹These use, as the name indicates, low-intensity, low-dose medication and, therefore, are low cost IVF cycles. The rate is per embryo transfer.

DONOR-RECIPIENT (EGG DONATION) CYCLES

NOTES
As previously noted, with two-thirds of patients achieving clinical pregnancy after fresh transfer of maximum of two embryos, this pregnancy rate is the best objective evidence for the superior quality of CHR’s embryology laboratory and overall IVF performance.

NOTES
Considering the high percentage of patients with Diminished Ovarian Reserve (DOR), CHR does comparatively few frozen embryo transfers (FET). Moreover, embryo quality of cryopreserved embryos is, of course, often not the best, considering the Center’s patient population.