Results: Alta Bates IVF Program

Alta Bates IVF and Donor Egg Program Results

Below are our live birth rate results for the two most common ART procedures: In Vitro Fertilization (IVF) with the woman's own eggs and Pregnancy Initiation with Donor Eggs for the years 2003 and 2004. To assure that you have a good understanding of these results we explain below the way results are reported:

Q. Why do we combine results for 2 years?
A. In a relatively small program such as ours, there is high random variation from year to year due to differences in patient mix and other factors.

Q. Why don't we present results from cycles completed since 2004?
A. Some of the births have not yet occurred and 2004 is the most recent year for which live birth data for All SART Member Clinics are available.

SART (Society for Assisted Reproductive Technologies) is a professional society under the aegis of the American Society for Reproductive Medicine which has been reporting clinic-specific results collected by member clinics, such as the Alta Bates IVF Program, since 1989. Thus the results for Alta Bates from 1989 through 2004 are in the public domain. CDC (Centers for Disease Control and Prevention) is a branch of the federal government which has been publishing U.S. national clinic-specific reports since 1995. However, the CDC report for 2004 is not yet available. The All SART Member Clinics' results are very close, albeit not identical, to the U.S. national results. For example, for women aged 38-40 years in 2003, the All SART Member Clinics' report includes 17,396 IVF cycle starts with a live birth rate of 20.3% whereas the U.S. national report includes 18,660 cycle starts with a live birth rate of 20.2%. The numbers presented below are weighted averages for the years 2003 and 2004 as reported by SART.

While the All SART Member Clinics' results provide a useful frame of reference for examining the live birth results in our program, we must caution you that a direct comparison of success rates between individual clinics may not be meaningful and may be misleading because patient medical characteristics and treatment approaches vary from clinic to clinic.

We include only live birth rates per cycle start because that is the only outcome which matters to most consumers. Thus early "biochemical" pregnancies, miscarriages, ectopic pregnancies, elective pregnancy terminations and stillbirths are all excluded. Success rates are fractions reported as percentages. When examining results from other clinics, it is advisable to pay close attention to what type of pregnancy is being reported (the numerator of the fraction). In general, overall or clinical pregnancy rates are higher than live birth rates because the former include miscarriages and other untoward outcomes. For example, in the 2003 CDC report for women aged 38-40 years the pregnancy rate per cycle start was 27% but the live birth rate per cycle start was only 20.2%. In addition to making sure that the numerators are the same, the denominators can also vary and include in descending order: cycle starts, retrievals and transfers. In general, live birth rates per cycle start are lower than live birth rates per transfer because the former include cancelled cycles in the denominator. For example, in the 2003 CDC report for women aged 38-40 years, the percentage of embryo transfers which led to live birth was 26.1% whereas the percentage of cycle starts which resulted in live birth was only 20.2%. Obviously the highest percentage is obtained by combining the largest numerator (overall pregnancy) with the smallest denominator (embryo transfer). Conversely the lowest percentage is calculated by using the smallest numerator (live births) with the largest denominator (cycle starts) which is what we have done here because we want our patients to have realistic expectations based upon most conservative data.

In Vitro Fertilization
Results:

In Vitro Fertilization results are provided for specific age groups because in IVF the woman's age is the single most important determinant of outcome. IVF is performed with embryos from each woman's own, i.e. non-donor, eggs. The following table and graph show the IVF live birth rates per cycle start when fresh embryos were used in the four standard age groups included in the SART report.

Woman’s Age	Live Birth Rates per IVF Cycle Start
Woman’s Age	Alta Bates (2003-2004)	All SART Member Clinics (2003-2004)
Under 35 Years	31% (15/49)	37% (27,223/73,489)
35 to 37 Years	43% (9/21)	30% (11,323/37,950)
38 to 40 Years	32% (14/44)	20% (7,001/35,279)
41 to 42 Years	3/12 25%	11% (1,7001/15,611)

Live Births Per IVF Cycle Start (2003-2004)

From 2001 through 2004 at the Alta Bates IVF Program 2 live births have occurred in 15 IVF cycle starts (13%) in women aged 43 years and above who used their own eggs. All these patients had good ovarian reserve (How We Test Ovarian Reserve?).

As the practice of IVF has evolved, frozen embryo transfers have come to play an ever greater role. Freezing of embryos is key to the goal of reducing the risk of high order multiple births which are associated with premature deliveries and place infants at risk for lifelong health problems. The table and graph below show the live birth rates per transfer of frozen-thawed embryos derived from non-donor eggs at the Alta Bates IVF Program in 2003 and 2004. For reference we are including the live birth rates for frozen embryo transfer after IVF by All SART Member Clinics in 2003 and 2004.

Woman’s Age	Live Birth Rates per Transfer of Frozen Embryos from IVF (2003-2004)
Woman’s Age	Alta Bates (2003-2004)	All SART Member Clinics (2003-2004)
Under 38 Years	29% (10/34)	29% (6,661/22,606)
38 to 42 Years	3/12 25%	22% (1,327/6,084)

Live Birth Rates per Transfer of Frozen Embryos
from IVF (2003-2004)

Donor Egg Treatment
Results:

Since the recipient's age has relatively little impact on the outcome of donor egg cycles, donor egg results include recipients of all ages. In 2003 and 2004 the average age of donor egg recipients at the Alta Bates program was 43 years.

Transfer Type	Live Birth Rates Per Transfer of Embryos from Donor Eggs
Transfer Type	Alta Bates (2003-2004)	All SART Member Clinics (2003-2004)
Fresh Embryos	47% (23/49)	51% (8,365/16,517)
Frozen Embryos	36% (16/45)	30% (2,289/7,564)

Donor Egg Live Birth Rates (2003-2004)

©2000-2008 Alta Bates In Vitro Fertilization Program.
Not reproducible without express permission. Please read Medical Disclaimer.

Alta Bates IVF Program - 2999 Regent Street #101A - Berkeley, California 94705 USA
Telephone: 510-649-0440 - FAX: 510-649-8700 - E-mail: abivf@pacbell.net

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