How successful is egg freezing? Fertility clinics don’t have to say

Article content

While CFAS publishes a general, national snapshot of fertility success rates using data from most known clinics, its annual report does not give results for individual clinics.

Article content

CFAS executive director Emily McIntosh said there is broad support for increased transparency around clinic-specific outcomes from fertility clinic owners who are members of the organization.

Article content

There is a “wide variability” of outcomes between clinics, said Dr. Arthur Leader, a University of Ottawa obstetrics and gynecology emeritus professor who obtained success rate data for some Ontario fertility clinics through a Freedom of Information request.

Article content

Arthur Leader, professor emeritus of obstetrics, gynecology and reproductive medicine at the University of Ottawa’s medical school, has long advocated for more transparency in the fertility industry. Photo by Courtesy of Arthur Leader

Article content

The anonymized data from 2019 that he received shows live birth rates for women under 35 at Ontario fertility clinics ranged from less than 10 per cent at the worst clinic to over 60 per cent at the province’s highest-performing clinic. Reasons for this variation can range from physician skill to the quality of lab environments, but without data, patients live in a “void,” said Leader.

Article content

“People are being asked to judge the efficacy of a clinic by the waiting room, the clinical staff — the nurses, the sonographers, the psychologists — without really having any clue as to what goes on in the back room.”

Article content

Article content

The U.S., U.K. and Australia do present searchable birth-rate data for individual clinics.

Article content

In the U.S., clinic-specific egg-freezing success rates are published by the Centers for Disease Control (CDC) in a searchable database that includes filters for age and medical challenges that can cause infertility.

Article content

In the U.K., clinics are legally required to share patient-outcomes data. The government’s searchable database includes the percentage of IVF treatments that result in live births.

Article content

In Canada, clinics provide their data for the CFAS report on a volunteer basis and don’t have to post their own clinic-specific data to their websites. There is no searchable database for patients.

Article content

‘A lack of clarity’

Article content

There is a distinct “lack of clarity” on how clinics define success, said TMU’s Hammond. Some, for instance, promote their services based on general outcomes in the age groups that are most fertile.

Article content

For example, the website for Ontario’s Anova fertility chain says “women between the ages of 30 and 37 have an 80 per cent chance of conceiving a child using frozen eggs.” It doesn’t provide a source for this statistic, and doesn’t state whether this rate applies to its own clinic. Anova did not respond to multiple requests for comment.

Article content

Article content

A number of centres don’t publish even general success-rate data.

Article content

Saskatoon’s Aurora clinic says one reason it doesn’t post its data is because “IVF success rates can be tricky to interpret.” Its website cites challenges in interpreting success rates, noting that “clinics can differ in the patient population they treat,” which can affect reported outcomes.

Article content

It urges people to find a “comfortable, convenient” clinic with a good medical team.

Article content

Article content

Clinics that publish success data can apply for a CFAS compliance seal, but only three, all of them private, have one: Ottawa Fertility Centre, Pacific Centre for Reproductive Medicine, and Olive Fertility in B.C. The seal indicates statistics are presented in a standardized way, but allows success to be based on “clinical pregnancy” — the first early sign of pregnancy captured by ultrasound, which is not the same as a live birth.

Article content

The U.K. government’s Human Fertilisation and Embryology Authority told its clinics in 2021 to be clear about live birth rates.

Article content

Some industry watchers argue clinics may use clinical pregnancy rates because they might not know their clinic’s live birth statistics if they don’t adequately track patient outcomes.