Selecting an ART Program
When selecting an ART program, information is crucial. Important points for
consideration include the qualifications and experience of personnel, types of
patients being treated, support services available, cost, convenience, live birth
rates per ART cycle started, and multiple pregnancy rates. Older programs have
established live birth rates based on years of experience. Small and new programs may still be determining their live birth rates, although their personnel
may be equally well qualified.
Every couple wants to use the most successful ART program, but many factors contribute to the overall success of a program. For example, some clinics
may be willing to accept patients with a low chance of success. A clinic may
specialize in certain types of infertility treatment. Costs may vary between
programs. A couple may prefer a program based upon interpersonal interactions
with the ART team or may feel more confident in the recommended treatment plan. Consequently, it may not always be appropriate to compare programs
based only on the published pregnancy rates.
Credibility is important too. Does the program adhere to the guidelines set forth
by the American Society for Reproductive Medicine
(ASRM)? Is the program a member of SART, a society affiliated with the ASRM? Is the IVF lab accredited by
the College of American Pathologists or by the Joint Commission? These organizations require ART programs to have personnel on their staff who have
been trained in reproductive endocrinology, laparoscopic surgery, sonography, hormone
measurement, tissue culture technique, and sperm/egg interaction. Are the physicians board certified in reproductive endocrinology and infertility? Does the
program report its results to SART/CDC? The compiled results are published in
Fertility and Sterility, the ASRM journal, and results are available on the SART
Web site at www.sart.org
and the CDC’s Web site at: www.cdc.gov/art.
The above considerations and answers to the following questions, which may
be asked of the program, will help you make an informed decision when choosing an IVF/GIFT program.
Cost and Convenience
What pre-cycle screening tests are required, how much do they cost, and will
my insurance provide coverage for these tests?
How much does the ART procedure cost, including drugs per treatment cycle?
Do I pay in advance? How much? What are the methods of payment?
If applicable, will you submit any bills to my insurance company?
How much do I pay if my treatment cycle is canceled before egg recovery?
Before embryo transfer?
What are the costs for embryo freezing, storage, and transfer?
How much work will I miss? How much will my partner miss?
Do you help arrange low-cost lodging, if needed?
Details about the Program
Does the program meet and follow
Does the program report its results to
Is the program a member of the
Society for Assisted Reproductive
How many physicians will be involved in my care?
Are one or more physicians board certified in reproductive endocrinology?
To what degree can my own physician participate in my care?
What types of counseling and support services are available?
Whom do I call day or night if I have a problem?
Do you freeze embryos (cryopreservation)?
Is donor sperm available in your program? Donor eggs? Donor embryos?
Do you have an age or basal FSH limit?
Do you do ICSI? If so, when? Cost?
Do you do assisted hatching? If so, when? Cost?
How many eggs/embryos are transferred?
Success of the Program
SART is a very good source of information to obtain ART outcomes for each
member program in the United States. This information may be a year old, so it
is important to find out if there have been any significant changes in the program
since the most recent report including:
Changes in the approach to ovarian stimulation, egg retrieval, embryo culture,
or embryo transfer.
Change in the number of cycles.
Change in the miscarriage rate, live birth rate per cycle started, or the multiple
If a program cites a live birth rate for each procedure, be sure that the program
representative counts twins as one successful pregnancy, not two. When discussing recent ART program outcomes, keep in mind that the live birth rate
may vary depending on the denominator used – i.e., per cycle started, per
retrieval, or per embryo transfer. For example, live birth rates per egg retrieval
do not consider cancelled cycles, and rates based per embryo transfer do not
include cancelled cycles or fertilization failures. Therefore, live birth rates per
cycle are higher per egg retrieval and are highest per embryo transfer.
For more information on the
success rates of IVF/GIFT programs in the United States, please click
To get information on clinics which perform Assisted Reproductive Technologies,
please visit the Society for Assisted Reproductive
The above information was
taken from the American Society for
Reproductive Medicine Patient Information Series
Reproductive Technologies", copyrighted 2007
by the American Society for Reproductive Medicine.
By accessing and using the
ASRM Web Site, you agree to be bound by
ASRM Web Site Terms and Conditions of Use.
View the ASRM
Non Discrimination Policy
Copyright 1996-2008 ASRM, All Rights Reserved
American Society for Reproductive Medicine
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