Driscoll, G. L., & Tyler, J. P. (1999). What is the best strategy for presenting ART results? A controversial comment. Journal of assisted reproduction and genetics, 16(9), 463-467. https://doi.org/10.1023/a:1020590614263
Driscoll GL, Tyler JP. What is the best strategy for presenting ART results? A controversial comment. J Assist Reprod Genet. 1999;16(9):463-467. doi:10.1023/a:1020590614263
Driscoll, G. L., and J. P. Tyler. "What is the best strategy for presenting ART results? A controversial comment." Journal of assisted reproduction and genetics, vol. 16, no. 9, 1999, pp. 463-467.
Doctors love conventions. They have them in exotic places and they frequently use them to defend what would otherwise be inexplicable calculations. Thus 38 weeks of true gestation is, of course, 40 weeks of amenorrhoea, which may also be viewed as 38–40 weeks of pregnancy if timing is based on a “conventional” menstrual cycle. Even if this leaves the outside world to wonder, the clinicians understand. Many of the proponents of such ambiguity have moved away from obstetrics into reproductive medicine but have carried with …
This study was designed to derive the predictive value of C-reactive protein (CRP) in peripheral venous serum of patients admitted to hospital with suspected premature rupture of the membranes (PROM). CRP was assayed by each of 4 separate methods and the results have been compared for accuracy and practical value with respect to clinical outcome and the histopathology of the placenta. Of the 4 techniques used only the latex test had characteristics suitable for a diagnostic screen. While the results were only semiquantitative, when comparisons were made to other techniques no significant change in clinical diagnosis would have been made. The results have confirmed that chorioamnionitis and preterm labour are often associated, but in some instances the extent of inflammatory infiltration was greater than might have been expected from the short time interval between documented membrane rupture and delivery. Thus it may be speculated that some cases of PROM are secondary to, rather than causative of, infection. Finally it is suggested that a controlled therapeutic trial of active intervention in those cases of PROM with elevated CRP in the absence of other clinical parameters suggestive of intrauterine infection should be undertaken.
Wilkinson J et al., 2017·BMJ Open·Free full text on PubMed Central
To establish how medically assisted reproduction (MAR) clinics report success rates on their websites. Websites of private and NHS clinics offering in vitro fertilisation (IVF) in the UK. We identified clinics offering IVF using the Choose a Fertility Clinic facility on the website of the Human Fertilisation and Embryology Authority (HFEA). Of 81 clinics identified, a website could not be found for 2, leaving 79 for inclusion in the analysis. PRIMARY Outcome measures reported by clinic websites. The numerator and denominator included in the outcome measure were of interest. 53 (67%) websites reported their performance using 51 different outcome measures. It was most common to report pregnancy (83% of these clinics) or live birth rates (51%). 31 different ways of reporting pregnancy and 9 different ways of reporting live birth were identified. 11 (21%) reported multiple birth or pregnancy rates. 1 clinic provided information on adverse events. It was usual for clinics to present results without relevant contextual information such as sample size, reporting period, the characteristics of patients and particular details of treatments. Many combinations of numerator and denominator are available for the purpose of reporting success rates for MAR. The range of reporting options available to clinics is further increased by the possibility of presenting results for subgroups of patients and for different time periods. Given the status of these websites as advertisements to patients, the risk of selective reporting is considerable. Binding guidance is required to ensure consistent, informative reporting.
The 2018 Assisted Reproductive Technology (ART) Fertility Clinic Success Rates Report, prepared under the Fertility Clinic Success Rate and Certification Act of 1992 (Public Law 102-493), presents data submitted to the Centers for Disease Control and Prevention (CDC) by 456 reporting fertility clinics in the United States, Puerto Rico, and the District of Columbia for ART cycles initiated during the 2018 reporting year. The report includes 203,119 ART cycles, 73,831 live-birth deliveries, and 81,478 infants born through ART. Clinic-specific data are presented for each reporting clinic and include fresh and frozen ART cycles using patients' own eggs and donor eggs, broken out by patient age band (less than 35, 35 to 37, 38 to 40, 41 to 42, and over 42 years). The 2018 Report introduced data suppression rules to suppress the publication of small numbers (1 through 4) to reduce the risk of patient identification. The Report also presents national summary figures and clinic table summaries, including cumulative success rates that combine fresh and frozen embryo transfers from a single oocyte retrieval. CDC estimates that the proportion of all ART cycles reported to the National ART Surveillance System (NASS) represents 97 to 98 percent of all ART cycles performed in the United States.
The 2019 Assisted Reproductive Technology (ART) Fertility Clinic and National Summary Report, prepared by the Centers for Disease Control and Prevention (CDC) under the Fertility Clinic Success Rate and Certification Act of 1992 (Public Law 102-493), presents data submitted by 449 reporting US fertility clinics for ART cycles initiated during the 2019 reporting year. The Report includes data on a total of 330,773 ART cycles performed and 78,889 live-birth deliveries. Beginning with the 2019 reporting year, clinic-specific ART success rates are reported in the ART Success Rates by Clinic online application instead of in the printed annual report; the 2019 publication consolidates the previously separate fertility clinic and national summary reports. Standard age bands changed for the 2019 reporting year to less than 35, 35 to 37, 38 to 40, and over 40 years. National summary figures present noncumulative data on cycles performed in the reporting year. CDC estimates that NASS captures 97 to 98 percent of all ART cycles performed in the United States. The 2019 Report includes information on cumulative success rates per intended retrieval cycle, fresh and frozen embryo transfer outcomes, donor egg cycles, embryo banking, and gestational carrier cycles.
The use of assisted reproductive technology (ART) for treating the infertile couple is increasing in the United States. The purpose of this paper is to review the short-term outcomes after ART. Pregnancy rates after ART have shown nearly continuous improvement in the years since its inception. A number of factors affect the pregnancy rate, with the most important being a woman's age. Certain clinical diagnoses are associated with a poorer outcome from ART, including the presence of hydrosalpinges, uterine leiomyomata that distort the endometrial cavity, and decreased ovarian reserve. Multiple gestations are the major complication after ART. New laboratory techniques, including extended embryo culture, may allow the transfer of fewer embryos to maintain pregnancy rates while reducing the risk of multiple gestations. Although much of the morbidity in children born after ART is the result of multiples, recent analysis suggests that even singletons are at higher risk for perinatal morbidity, including preterm delivery and small for gestational age infants. In vitro fertilization may be associated with a slight increased risk for birth defects. The major short-term complication of ART in women is the development of ovarian hyperstimulation syndrome. This syndrome is difficult to predict, but new treatments are being developed that may limit its frequency. Because of its high pregnancy rate, couples are moving to ART more quickly in the management of their infertility. All outcomes of ART, including pregnancy rates and adverse complications, need to be compared with standard non-ART therapy when deciding the appropriate course of treatment for a given couple.
PMID 10530397 10530397 DOI 10.1023/a:1020590614263 10.1023/a:1020590614263 Driscoll et al. 1999, Driscoll 1999
Cite this article
Driscoll, G. L., & Tyler, J. P. (1999). What is the best strategy for presenting ART results? A controversial comment. Journal of assisted reproduction and genetics, 16(9), 463-467. https://doi.org/10.1023/a:1020590614263
Driscoll GL, Tyler JP. What is the best strategy for presenting ART results? A controversial comment. J Assist Reprod Genet. 1999;16(9):463-467. doi:10.1023/a:1020590614263
Driscoll, G. L., and J. P. Tyler. "What is the best strategy for presenting ART results? A controversial comment." Journal of assisted reproduction and genetics, vol. 16, no. 9, 1999, pp. 463-467.
Keywords
Benchmarking, Data Interpretation, Statistical, Embryo Transfer, Female, Fertilization in Vitro, Humans, Pregnancy, Pregnancy Outcome, Pregnancy Rate
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