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Designed for patients new to infertility treatments, our "infertility 101" covers infertility conditions, diagnoses and treatments.
The Table above, and Figure 2 on the left summarize CHR's 2012 clinical IVF pregnancy rates by age. At CHR, this usually means that these young patients suffer from severe premature ovarian aging (POA), sometimes also called occult primary ovarian insufficiency (OPOI).
Some further explanations: Here reported pregnancy rates are "clinical" pregnancy rates, meaning that we do not count the so-called chemical pregnancies as pregnancies. This, of course, raises the question: how many patients did not have at least one embryo for transfer?
A brief explanation as to why CHR presents pregnancy rates by embryos transferred: If a woman at retrieval produces no eggs, she, of course, has no chance of pregnancy. Likely reflecting CHR's cautious attitude towards Eco-IVF ("Mini-IVF"), 2011 cycles were too few for a valid statistical assessment. Here, too, CHR demonstrates a dramatic improvement in clinical pregnancy rate (42.3%), likely, reflective of overall improvement in embryo quality. At first glance, one could conclude that pregnancy rates in donor egg cycles at CHR have decreased over the last two years from a peak in the mid-60% in 2009 to ca. Such statistical outcome data represent mean values, a very appropriate way of presenting data when the range of outcomes is relatively narrow. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising.
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Designers Manufacturers , ??????? ????????? - ?????????? ???????????? , Gorgian Wikipedia - Free Encyclopedia , ????????? ?????? ????????? , Cambridje Dictionary Online , ????????? ???????? ????????? ?????? ????????? , Oxford Advenced Learner's Online Dictionar? , ??????????? ?????? - moazrovne,net, ??? Though, once again, our center's IVF pregnancy rates were more than excellent, the degree of excellence does not even become fully apparent until the adverse selection of patients undergoing IVF cycles at CHR is considered. A few peculiarities deserve explanation: For example, one may wonder why younger women, under age 30 years, have poorer pregnancy rates than women between 30 and 40 years.
Indeed, during 2012, CHR served a larger number of young women with severe POA than ever before, many with undetectable AMH levels and FSH levels approaching menopausal levels. Approximately 90% of women under treatment suffer from POA, either based on abnormally low age-specific AMH, abnormally high age-specific FSH levels, or both. Considering that CHR, up to age 38, practically never transfers more than 2 embryos and up to age 40 never more than 3, this is, again, quite a remarkable number. The same applies to when a woman with PGD only has chromosomally abnormal embryos that cannot be transferred. Indeed, the data very well demonstrate the continuing "graying" of CHR's patient population as IVF cycles in the oldest age groups increased the most. In presenting the above data, we, however, also want to point out once more that statistical data has to be interpreted with extreme caution in medicine. In women with significantly diminished functional ovarian reserve (DFOR), whether due to POA or older age, the range of outcomes, however, becomes much wider and, most importantly, with significant risk involves the ZERO range (i.e. The pie chart in Figure 1 on the right demonstrates, for example, how adversely selected CHR's patients were in regards to age: only approximately 30% of patients were under age 35.
This, however, is an almost expected finding at our center: Women who seek out fertility treatments at such young ages are usually more severely affected by infertility.
Among the patients who went through full stimulation, even with approximately 20% also undergoing preimplantation genetic diagnosis (PGD), only 19.8% ended up with no embryo for transfer.


All patients who received 4 or more embryos were above age 41, and in such patients a clinical pregnancy rate of 15.6% is remarkable.
On more careful analysis, however, this conclusion is proven wrong because standard donor egg cycles, indeed, still demonstrated pregnancy rates around 60.0% in 2011. No two patients are ever 100% alike, and looking at outcome data, based on patient age alone, especially for older women, is not always the best way to asses individual patient's pregnancy chances. It is for that reason that CHR above, for the first time, reports clinical pregnancy rates by the number of embryos transferred. Especially at centers like CHR, where patients seek treatment usually only after having failed treatments elsewhere (often more than once), presenting young patients almost always have very severe fertility problems. Again, considering this degree of adverse patient selection, CHR's age-specific cycle outcomes have to be considered nothing but spectacular.
This means that to be included in these statistics, a patient had to have at least one embryo available for transfer. Within each number of embryo transferred, younger patients, of course, will do better than older patients, though the range of difference narrows as women age. The decline observed here is due to important new developments in the center's egg donation program: (i) An increasing number of patients chose to use so-called "directed" (open) egg donors, often family members or friends, who frequently do not fit the strict criteria of donor selection, which characterize CHR's own egg donor pool. For example, if a woman at retrieval produces no eggs, she, of course, has no chance of pregnancy.
The same applies to when a woman with PGD only has chromosomally abnormal embryos that cannot be transferred.



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