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Comment and Controversy

CDC’s protocol allows ART clinics to game the system

September 2005 · Vol. 17, No. 9

In his July editorial, “Too many embryos for one woman,” Dr. Robert L. Barbieri questioned how we define success in assisted reproduction. I agree that this issue needs to be addressed. The system for reporting assisted reproductive clinic outcomes to the Centers for Disease Control and Prevention (CDC) offers the wrong incentives. As long as the CDC makes overall live birth rates the standard, too many embryos will continue to be transferred.

I suggest using the rate of live births per embryo implanted. This would offer patients a more controlled means of comparing programs and would not encourage programs to “improve” their numbers by transferring too many embryos. We have come a long way since the first IVF baby was born in 1978, and our specialty is a leader in informing patients about treatment outcomes. The American Society for Reproductive Medicine, the Society for Assisted Reproductive Technology, and the CDC have worked to give infertility patients access to more comparative data and information than patients in any other field of medicine. However, we have a long way to go—and no good reason to avoid a simple, logical next step.

Serena H. Chen, MD
Director, Division of Reproductive Endocrinology
and Infertility, Saint Barnabas Medical Center;
Director, Ovum Donation, Institute for
Reproductive Medicine and Science, Livingston, NJ;
Associate Clinical Professor, Mount Sinai School
of Medicine, New York City

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