Abstract
Defining success in assisted reproductive technology (ART) has proved to be surprisingly contentious. Traditionally the prerogative of clinics, rather than patients, the choice of criteria for success has been shaped by clinical and laboratory considerations, ease of collecting and reporting data, and the need to appear competitive. Pregnancy rates per fresh cycle of treatment were the original favored indicator of treatment success, but live birth is now perceived to be a more robust end point. In recent years, the thinking surrounding in vitro fertilization (IVF) has matured to an extent where safety is acknowledged as an important end point of treatment and multiple pregnancies perceived as complications of ART. The logical extension of this is the view that the ideal outcome of ART should be a singleton live birth [1], but this concept has generated much debate within the specialty [2]. This chapter will review the case for reporting outcomes in ART, assess the appropriateness of those in current use and consider alternative ways of defining success. Why report success in ART? An outcome parameter has been defined as a “measure enabling the clinician to study, understand and eventually control variables that influence the success of a therapy” [3]. Reasons for defining and reporting success in ART are summarized in Table 19.1. Without a clear understanding of the desired end point of an intervention, it is impossible to gauge the effect of treatment, compare alternative modalities, evaluate clinic performance, identify adverse events, perform research or organize service delivery.
Original language | English |
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Title of host publication | Single Embryo Transfer |
Publisher | Cambridge University Press |
Chapter | 19 |
Pages | 231-240 |
Number of pages | 10 |
ISBN (Electronic) | 9780511545160 |
ISBN (Print) | 9780521888349 |
DOIs | |
Publication status | Published - 2008 |
Bibliographical note
Publisher Copyright:© Cambridge University Press 2009.