Study Reveals Significantly Inflated Live Birth Rates Due to Increasing Utilization of Embryo Banking in National In Vitro Fertilization (IVF) Data Set

    NEW YORK, NY, May 11, 2016 /24-7PressRelease/ -- A study published in the medical journal PLoS One by investigators from New York City's Center for Human Reproduction (CHR) raises serious questions about the accuracy of federally mandated outcome reporting by U.S. IVF centers. Examining national IVF cycles reported in the 2013 Assisted Reproductive Technology (ART) reports generated by the Centers for Disease Control and Prevention (CDC) under Congressional mandate, CHR investigators discovered that a new treatment approach to IVF called embryo banking, increasingly utilized by some IVF centers, results in significantly inflated reporting of national IVF outcomes. The study in addition demonstrated a counterintuitive selection bias in utilization of embryo banking in women of advanced female age.

Embryo banking means that, instead of immediately transferring embryos into the uterus following an IVF cycle, they are cryopreserved (frozen) to be thawed out and transferred into the patient's uterus at a later stage. Embryo banking has gained popularity among some IVF centers in recent years, though its routine utilization has remained controversial. This study did not attempt to determine the clinical value of embryo banking but investigated its impact on national IVF cycle outcome reporting. The 2013 report of IVF cycle outcomes generated by the CDC excluded embryo banking cycles from outcome calculations.

Though little clinical rationale exists for embryo banking in older women who usually produce few and rather poor-quality embryos, this study, surprisingly, demonstrated that utilization of embryo banking increased with advancing patient age. This counterintuitive finding, therefore, suggests that the poorer a patient's outcome prognosis was due to advancing age, the more likely did her cycle involve embryo banking and excluded from outcome calculations in the CDC report. Indeed, embryo banking cycles increased from 15.5% in women under age 35 to 56.5% in women above age 44 years; yet concomitant thaw cycles to a highly significant degree (P_0.0001) declined with advancing female age. This finding suggests that the older the patient, the less likely that her embryos were to be subsequently transferred into the uterus. Exclusion of these poor-prognosis patients from reporting, of course, led to significant inflation in reported national live birth rates.

The same group of CHR investigators, in an earlier publication, reported that a small group of IVF centers disproportionally utilized embryo banking, thereby artificially inflating their IVF outcomes and increasing their market share of IVF cycles over an observation period of some years. Recognizing some of the shortcomings of current national IVF outcome reporting, the Society for Assisted Reproductive Technologies (SART), a daughter organization of the American Society for Assisted Reproductive Medicine (ASRM), recently announced major modifications to its voluntary reporting system. However, the CDC has not yet made modifications to its statutory reporting system. This study strongly suggests that particular attention has to be paid to embryo banking, which distorts real IVF outcomes not only on a clinic level but also nationally.

CHR is nationally and internationally recognized as a leading clinical and research center in reproductive medicine and biology. Vitaly A. Kushnir, MD, the study's lead author and Norbert Gleicher, MD, senior author and Medical Director and Chief Scientist at CHR, are available for further comments.

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