Taco Bout Fertility Tuesday

Lies, Damn Lies, and IVF Statistics

• Mark Amols, MD • Season 7 • Episode 41

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Are fertility clinics telling you the whole truth about their success rates? In this episode, Dr. Mark Amols breaks down the hidden math behind IVF statistics — and exposes how “creative marketing” can make average results look amazing.

Learn why pregnancy rates don’t always mean babies, how clinics use “per transfer” versus “per cycle” numbers to their advantage, and what to look for in real CDC data before choosing a fertility center.

From the “we take the toughest patients” myth to the truth about PGT and donor egg statistics, you’ll walk away knowing how to read through the hype and make sense of the numbers that actually matter — the ones that lead to a baby in your arms.

🎧 Listen now to become a fertility stat detective and discover the truth behind the numbers.

Thanks for tuning in to another episode of 'Taco Bout Fertility Tuesday' with Dr. Mark Amols. If you found this episode insightful, please share it with friends and family who might benefit from our discussion. Remember, your feedback is invaluable to us – leave us a review on Apple Podcasts, Spotify, or your preferred listening platform.

Stay connected with us for updates and fertility tips – follow us on Facebook. For more resources and information, visit our website at www.NewDirectionFertility.com.

Have a question or a topic you'd like us to cover? We'd love to hear from you! Reach out to us at TBFT@NewDirectionFertility.com.

Join us next Tuesday for more discussions on fertility, where we blend medical expertise with a touch of humor to make complex topics accessible and engaging. Until then, keep the conversation going and remember: understanding your fertility is a journey we're on together.

Today we talk about lies. Damn lies. And IVF statistics. I'm Dr. Mark Amols, and this is Taco about Fertility Tuesday. Today, we're going to talk about something every fertility clinic loves to brag about. They're numbers. But are those numbers really telling the truth? Are they just creative math with a sprinkle of marketing sauce? That's what we're going to talk about today. Let's be honest. Success rates sound simple. You see, One clinic says 80%, another says 60%, and you think, well, duh, I'm going to go with the 80% one. That makes sense. But here's the problem. Fertility stats can be technically true and still completely misleading. Now, some cliques do play it straight, and others play it a little bit strategic. And the goal today is to help you become a stat detective, someone who can tell the truth from the trick. Pregnancy rate versus live birth rate. Here's one of the biggest traps. Clicks like to brag about their pregnancy rates, but the only rate that really matters is the live birth rate. Because a positive pregnancy test doesn't mean a baby. It just means a positive test. Some clinics stop tracking after the heartbeat, but it's not the heartbeat that we want. We want babies. So make sure when they're telling you their rate, make sure you find out the live birth rate. That is the statistic that will tell you you have a baby in your arms when all is said and done. Per transfer versus per cycle. So let's talk about another stat, per transfer versus per cycle rate. If you do one egg retrieval, make five embryos, and do two transfers, your first one might not work, but the second might. So your per transfer rate might look lower, but your cumulative success rate mean the total chances of getting pregnant from that one retrieval is much higher. So a clinic may brag about having an 85% success rate, but the question is, is that the cumulative rate or is that the rate per transfer? You can also look at it from another point of view. What if you want to know if you can build a whole family from, let's say, one cycle? Well, even if they have a high cumulative pregnancy rate, you may eventually get pregnant, but the per transfer rate is what's going to allow you to get multiple pregnancies. So a clinic with a low per transfer rate, you may still come away pregnant eventually. But getting multiple pregnancies from it is going to be less likely. Who is getting counted now? here's where things can get a little sneaky. Some clinics only include their best prognosis patients, women under 35, normal weight, perfect labs, and leave out the cycles that get cancelled or patients with poor response. They're not lying about the statistics. They're just saying, hey, this is our pregnancy rate or live birth rate. But you need to make sure there's not an asterisk next to it saying that, hey, this is only for certain patients. It's like saying you have a five star review, but you delete all the bad reviews. If you don't include everyone, the stats really don't mean much. Now, that doesn't mean you can't look at your age group. You, you should. Matter of fact, you should actually even look at your situation and see what the pregnancy rate is for that. But that's using something like the CDC data I'm talking about. When someone in marketing talks about their rate, you need to make sure, well, what is that rate really representing? If that rate is only donors and you're 41, that's not going to be your rate. PGT and donor cycles skew the picture. So sometimes in marketing, some clinics will include donor eggs and PGT A embryos in their success rates. Of course those rates are going to look high because those embryos have already passed the genetic exam or have high chances. This is why I mentioned, if you're comparing clinics, compare your situation. That clinic may be amazing at women under 35, but what about their 42 year old rate? Is that as good? Maybe they're not as good in that area. The point is you need to look at the picture and make sure it's not being skewed. We take the toughest patients myth. Yeah, this one's my favorite. I love how clinics say, oh, we take tougher patients, that's why our numbers are lower. And listen, that is a valid case. Of course, if you are taking the hardest patients in the world, you're probably going to have lower pregnancy rates than everyone else. No one's arguing that. The problem is it's not always true. And there's a very easy way to determine this. All you need to do is go to the CDC success rate and look at the category percentage of new patients having live birth deliveries after one intended retrieval. These are new patients with no prior art cycles. So my point is, if they've already had failed IV apps and they're tough cases, I appreciate that. But this is going to be really a group coming in without ever going through treatment. So it's hard to say that your success rates are lower because you're using harder patients when your new Patients with no prior art are still low. The M point is if the first timers don't do well either, maybe it's not just the tough patients. There's a clinic that my clinic gets compared to a lot of times and they like to use this myth. But when you look at that rate, that should be your highest rate because that has only the non complicated patients and that rate of theirs is still very low. So that myth is busted. Implantation rate versus pregnancy rate. Here's a sneaky one. Implantation rate. That means how many embryos stuck per embryo transfer. So a, ah, 50% implantation rate doesn't mean 50% of the patients got pregnant. It just means half of the embryos did. Now technically, if you're only putting back one embryo at a time, then your implantation rate will be very similar to the pregnancy rate. But there's two things here to point out. One, a clinic can have a high pregnancy rate and a low implantation rate. If that clinic is putting back four embryos in everyone and they have a very high pregnancy rate, that may be true. But the implantation rate might only be 25%, meaning only one out of four embryos implants. In that situation, you can't compare the live birth rates because of the fact that the implantation rate is just so low. Basically, it's taking that clinic more embryos to get to the same success rate. The second thing is implantation rate is not live birth rate. So even if that's high, it's important to still look at the live birth rate because that's the number that tells you whether your baby will be in your arms in the end. Sample size and small numbers. If a clinic says they have 100% success, ask how many patients that's based on. If it's two out of two. Well, yeah, technically that's 100%, but that's not science, that's just luck. The bigger the sample size, the more reliable the number. So what I'm saying is if you're looking at two clinics and you see one clinic with 50 transfers over the year, and they have a very high rate, that could just be chance versus a clinic that has, let's say, hundreds to a thousand transfers in a year, their numbers are going to be closer to the truth. Think of it like if you were playing basketball. If you bring me outside and let me shoot three shots, I may look like an NBA player, but if you have me take 100 shots, you're going to realize I'm not an NBA player. Although it's probably pretty obvious. Anyways, the point is sample size matters. And so when you look at these numbers, it's always important to look at that a boutique clinic that only does 50 cycles a year might have really good numbers as they cherry pick things and only have small numbers to base their statistics off of. The point is, take this into account when you're looking at clinics. Okay, this is all great advice, but how do you check this for yourself? Well, one, obviously check with your clinic and then go straight to the source, the CDC. Every clinic has to send their data to the CDC. Yes, there's other places like SART, but SART's very difficult to read. That's why most people go to the CDC to look at the success rates. It's also the only source that's actually legally required to send to SART is more of a boys club. So yeah, they may send it there, but in reality the only one that they absolutely have to send to is the cdc. Here you can use multiple tools to be able to look at the success rate, look at their transfer rate, their implantation rate. You can even look at what their statistics are for each type of diagnosis. This will allow you to really be able to find out what clinic is the best for you. So if you're looking at what clinic you want to go to, the questions you need to ask are, what is the live birth rate per transfer for your age group? You want to ask how many patients does that include? Is it a small number or a big number? And do they exclude cancer cycles or donor eggs in that data? One interesting statistic on the CDC is the category percent of intended egg retrieval cycles without any eggs retrieved. What this essentially represents is either patients who were cancelled or where the eggs were not able to be retrieved, such as if someone had one follicle and they didn't get an egg. But most of it is cycles cancelled. A clinic that is cherry picking is going to have very high numbers here and that's because they're canceling a lot of cycles before they get to the egg retrieval. In the end, remember, numbers aren't bad, they're just tools. But you have to understand what they actually measure. Because when it comes to ivf, your success isn't about being a statistic, it's about being you. So next time a clinic brags about their numbers, remember, statistics can be twisted. Go to the source. In a future episode, we're going to go over the cost to baby or time to baby. This is another fascinating concept because when you think of your Chances of Getting pregnant the next question is the cost of baby. Even if your chances are 80% of getting pregnant at one place, but it costs $20,000 and your chances are 60% another place and it's $5,000, technically that would be your highest chance because four times $5,000 at 60% each time would have a higher cumulative pregnancy rate than the one time at the other clinic. That podcast will be with my friend Steve Rooks, who is the master of analytics. It's definitely one you don't want to miss. Hopefully you like this podcast. Maybe you've always wondered if your clinic was a good clinic that you went to. Or maybe you're trying to decide which clinic you want to go to. Hopefully this episode helped you. And as I mentioned, the CDC is a great site to go to to learn about this. If you go to cdc.gov just put in art and then you'll see a link for art success rate. At that point you can then look at all the data and figure out what's best for you. As always, I greatly appreciate everyone who listens to this podcast. If you like us, give us a five star review and tell your friends about us. But most of all, keep coming back. I look forward to talking again next week on Taco Bell Fertility Tuesday.

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Mark Amols, MD

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