Reporting assisted reproductive technology success rates on Australian and New Zealand fertility clinic websites

Abstract

Background Fertility clinics commonly report their success rates online. These can be difficult to interpret as they are influenced by the way the data are presented. To improve transparency, the Reproductive Technology Accreditation Committee (RTAC) has published guidelines to support fertility clinics with their online reporting of success rates. However, it is unclear whether compliance with these guidelines will allow patients to make fair comparisons between clinics. Aims To illustrate the variability in patient and treatment populations that contribute to fertility clinic published rates. Materials and Methods Fertility clinics offering in vitro fertilisation treatment in Australia or New Zealand were assessed for compliance with six guidelines adapted from RTAC’s code of practice, for reporting success rates in the public domain. All graphs and/or tables reporting clinic success rates were assessed to illustrate the combination of outcome or treatment variables contributing to each dataset. Results Twenty of the 30 fertility clinic websites reported success rates. Of these only 17 reported live births. The median compliance score with RTAC guidelines was 8/8 (interquartile range: 6–8). Of 41 figures published across all websites, five reported clinical pregnancy rates as their only outcome measure. Thirty‐seven figures reported success rates ‘per embryo transfer’, two figures used ‘per egg collection’, and no figures described success rates ‘per cycle started’. Thirty‐two different combinations of reporting variables were observed. Conclusions Websites were broadly compliant with RTAC’s guidelines. However, considering the variability in patient and treatment groups contributing to success rate data, patients cannot be expected to make an informed decision based on clinics’ self‐reported outcomes. RTAC guidelines could be improved by providing a clear definition of success, including the appropriate use of denominators.

Reporting IVF outcomes: The devil is in the detail

“…With no data about individual clinics available from ANZARD, the other source of publicly available information is clinic websites. In this issue of ANZJOG , Professor Farquhar and colleagues from the University of Auckland investigated how individual ART clinics report treatment outcomes on their websites . The authors identified 30 unique websites and found that 20 reported success rates .…”

“…In this issue of ANZJOG , Professor Farquhar and colleagues from the University of Auckland investigated how individual ART clinics report treatment outcomes on their websites . The authors identified 30 unique websites and found that 20 reported success rates . Therefore, out of a total of roughly 90 clinics, there are no publicly available outcome metrics for almost 80%.…”

“…In contrast, the CDC and SART report clinic‐specific data for >90% of US clinics and in the UK, it is a requirement of licensure that all clinics report their outcomes to the HFEA, which then makes the data available online. Worryingly, the authors observed that the number of clinics disclosing their success rates in Australia and New Zealand is on the decline, from 32/29 in 2016/2017 to 24 in 2018 and now, to only 20 …”

“…RTAC’s Code of Practice provides guidance regarding how outcomes should be presented by clinics in the public domain . In their paper, Goodman et al assessed compliance of clinic websites with six RTAC guidelines . Given the overarching importance of oocyte quality for pregnancy chances, perhaps the most obvious rule when presenting IVF outcomes is that they be female age‐specific in keeping with which, RTAC stipulates that outcomes be grouped according to specified age ranges .…”

“…Given the overarching importance of oocyte quality for pregnancy chances, perhaps the most obvious rule when presenting IVF outcomes is that they be female age‐specific in keeping with which, RTAC stipulates that outcomes be grouped according to specified age ranges . Sixteen of 20 clinics adhered to these requirements . However, four sites did not present outcomes in relation to age groups.…”