Compare apples with apples. For example, if you are 38 years of age, don’t look at the outcomes for the patients under 35 years of age to estimate your chances at a particular clinic. Likewise, if you are using your own eggs, do not look at the outcomes for women using donor eggs. Donor egg outcomes are useful only to assess the best possible outcomes that a particular clinic can deliver- so if this is low- then run like hell. If the clinic can’t deliver better than average outcomes with their donor egg cycles- they will be likely deliver even worse results with their other patients.
Clinics like to quote their pregnancy rates per transfer because this is their best case scenario. It excludes all their patients that reach retrieval but didn’t get to transfer and also excludes all their patients who got pregnant but didn’t make it to a live birth. The most useful statistic for choosing a clinic is live births per retrieval because this gives you an estimate of your chances of bringing home a baby with all the patients included, not cherry picking the data from the most successful time points and patients. Once you get to transfer, then pregnancy rates per transfer become relevant, but they are not much use for choosing a clinic.
About difficult patients. Clinics and organizations that collect statistics stress to consumers that clinic statistics are also affected by the number of “difficult” patients the clinic has. While this is true on the face of it, it ignores the fact that smart clinics quickly guide difficult patients to treatments like ICSI or donor egg that are more likely to work- precisely so it will not hurt their clinic statistics! Because of this, I think the effect of “difficult” patients is a wash at the end of the day- and in some cases, unfortunately, may be used as an excuse for underperforming clinics.
AFTER STATISTICS – OTHER FACTORS TO CONSIDER
After you have found one or more good clinics in your area, the next step is to schedule an introductory appointment with the physician you want to hire. You will probably be charged for this appointment so be sure to ask what the fee will be up front.
You will want to ask your doctor how the clinic staff communicates case results on a daily basis. Will the nurse call you or the embryologist? If you want to talk to the embryologist, is that encouraged? Is the lab accredited?