True or false; U.S. IVF centers are required by law to report their success rates? True! Since 1992 reproductive specialists have been required by federal law to report their success rates and other clinical data to the Centers for Disease Control (CDC). That data is then reported by the Society for Assisted Reproductive Technology (SART.org) every year.
Since data includes live births, the reported data lags by two years. The next batch of success rate data to be reported by SART is for 2020 and should be available online in the coming weeks. With this in mind, we sat down the Glenn Proctor, Lab Director at Conceptions here in Denver to talk about SART and why success rates can be very different from one IVF center to another.
Why should patients take an interest in SART?
Glenn: SART stands for the Society for Assisted Reproductive Technology and it’s their job to keep all 480 or so U.S. IVF centers in check when it comes to reporting IVF success rates. It’s a very strict professional organization, so when you look up a clinic’s success rates online you can trust that the data is accurate and that others are held to the same standards. You can look up success rates by all US IVF centers at www.sart.org.
SART is kind of the referee on the playing field of IVF making sure that all the centers’ report by the same rules and metrics. I still have the Super Bowl top of mind (laughs).
What are the current live-birth rates for Conceptions?
GP: Our current live birth rates for the year 2021 are around 65% per transfer. For 2020 which is about to be published by SART, we’re about 10 pts above the U.S. average. We’ve been above the U.S. average for several years and a big part of that success has been the changes in the IVF lab.
Some IVF centers in Colorado and across the U.S. talk about success rates per transfer, some per patient, what would you recommend to a patient to research?
GP: Both are good benchmarks to use if you’re a patient thinking about fertility treatment. However, I think per transfer is the best number to look at first because there are a lot of obstacles you must overcome as a patient. It doesn’t happen often at our center but not every patient gets to the embryo transfer stage in a cycle.
When you look at live birth rates per retrieval, this throws you into a huge group of people with various diagnoses. I think with live birth per transfer, you’ve overcome all those initial steps. That’s the category that says, “hey, I have an embryo, it’s ready to transfer, what’s the percentage that you might take home a baby?”
Again, live birth per transfer equates to embryo quality which is very lab dependent. Not all IVF centers use the same processes or procedures in the IVF lab which can have a huge impact on success rates.
On a scale of 1 through 10, how important is the lab in the success rate story?
GP: It’s an 11. The ability to take care of sperm and eggs, from the time they leave the body, all the way to fertilization, it’s solely dependent on the lab environment and skillset of the embryologist. I can’t stress enough how important that is. That’s what I personally think sets a lot of clinics apart regardless of physicians and stimulation protocols.
The skill set of the embryologists is especially important when it comes to techniques and processes like PGT-A, embryo biopsy, and cryopreservation all of which have a big impact on overall success rates and the numbers you see reported by SART.
What makes up a great IVF lab in Denver or anywhere?
GP: In a nutshell, a commitment to consistency and safety by some very talented and smart people. We perform quality control assessments, frequently for air quality, equipment calibration, and culture media pH – that’s a really big factor. Every lab has protocols that they follow within a range, it’s the same thing as not all surgeons are created equal, and not all embryologists are created equal. Every case is the same but also different.
Cryopreservation technique is also huge. Preserving the eggs and the embryos and then taking them out of that cryopreserved state requires skill. Embryologists need to be on top of their game when it comes to management and safety, and top of their game with cryopreservation techniques.
And at the end of the day, even though we don’t physically interact with the patient a lot, we see those embryos as our patients too. We keep a good bedside manner in the lab and treat them as the precious cells that they are. It’s crazy important.
Sounds like the embryology team at Conceptions is on 24/7/365?
GP: Yes, that’s true! Last Christmas we worked on Christmas Eve through Christmas Day for egg retrievals and embryo transfers. Mother Nature waits for no one. It’s just the kind of commitment you need to have as an embryologist. But when you meet a patient and learn their story it’s easy to go above and beyond for them.
This is a very stressful job. I do my best to support the team through the hard days and celebrate our successes.
And what’s the culture like with your team? Can you describe the team a little bit?
GP: We’re like a little family, a family of science geeks but a family. We take our jobs very seriously, but we have a lot of fun. Everyone is equally committed to getting the best outcomes. It’s very important to us, to the point where we have little friendly competition to see who has the best fertilization rates or birth rates (laughs).
So, in the IVF lab, you’re watching everything all the time, right?
GP: Yes, we’re constantly monitoring everything, we do daily checks and inspections. We were the first U.S. IVF center to use the latest cryo storage systems from a company called TMRW Life Sciences. This new platform uses automation to track and watch over eggs and embryos 24/7/365. Success has to go hand in hand with safety.
A good embryologist is always a little paranoid about anything that could happen, but the TMRW platform definitely relieves some of that stress and paranoia. So it’s not only our team that’s watching patient eggs and embryos but TMRW has remote support looking at conditions in the cryo tank.
As an embryologist you’re mostly behind the scenes, but do you and your team get to talk to patients at all?
GP: We give them their fertilization updates, ID them for egg retrieval, we talk to them on the biopsy days. We’re the ones that call with the genetic results and the ones who often bring the patient back for their embryo transfer. We love connecting with patients, it humanizes things. It gives the embryologists a good connection with the work they’re doing in the lab.
Over the last 10 years or so, what do you think have been the most important contributions to improving success rates?
GP: Good question. I think the ever-evolving genetic testing field, PGT-A has gotten a lot more in-depth, and we’re able to see things that we couldn’t see before. We see a lot of things that point us to healthy embryos becoming healthy babies.
What about cryo-preservation? How important has that become in the last 10 years?
GP: Equally very important. We’re doing a research project right now at Conceptions to improve thawing success rates. While thaw rates are high, around 90%, we think we can do better. The research is looking very promising, we’re hoping to present it at a national meeting later this year.
Okay so tell me, what made you want to become an embryologist?
GP: My background was in biology, and this is that, but on steroids. A lot of steroids (laughs). It’s kind of an icebreaker when I meet new people and they ask what I do, they almost don’t really believe what you do or that it’s even possible. It’s just cool, and it’s ever-changing which is fun. Every year, there’s some new breakthrough, procedure, or piece of equipment, that makes our job easier or more exciting.
What do you love about embryology?
GP: The joy of seeing patients succeed. The basic concept of putting two things together- the sperm and the egg- and we create this complex thing, and every embryo looks different. And the egg quality of the embryo, that’s a huge sense of achievement. Ultimately, you feel like you’re helping people.
I’ve talked to patients who failed elsewhere and come to Conceptions. They’re blown away that they are talking with the embryologist on their case. Success isn’t just the numbers published by SART, it’s the families we help to build and the lives we change for the better.
About Conceptions Reproductive Associates of Colorado
For over 20 years, Conceptions Reproductive Associates of Colorado has been a pillar of success and hope for patients across Colorado and around the world with clinical outcomes that meet or exceed US benchmarks. Whether you live in Cherry Creek, Lone Tree, and Littleton, or you’re visiting us from Colorado Springs, Los Angeles, or Chicago, our team of experts has deep roots in the Colorado community and is dedicated to a safe and successful experience. Visit Conceptions today to learn more.