What do consistently high-performing in vitro fertilization programs in the U.S. do?

Area of Science:

• Reproductive Medicine
• In Vitro Fertilization (IVF)
• Clinical Practice Research

Background:

• Identifying best practices in IVF is crucial for improving success rates.
• High-performing IVF programs may offer insights into optimal clinical and laboratory protocols.

Purpose of the Study:

• To identify common clinical and laboratory practices employed by consistently high-performing IVF programs.
• To understand the factors contributing to superior outcomes in assisted reproductive technology.

Main Methods:

• A questionnaire-based study was conducted on selected academic and private IVF programs.
• Ten programs with consistently high singleton delivery rates per cycle were included.

Main Results:

• Common clinical practices included comprehensive patient testing (ovarian reserve, endometrial defects, hydrosalpinges), mixed gonadotropin stimulation protocols with step-down dosing, and ultrasound-guided embryo transfer (ET).
• Laboratory practices featured selective intracytoplasmic sperm injection, group embryo culture in microdrops, and blastocyst ET in select cases.
• Optimal laboratory conditions included high air quality with filtration and heated stages for oocyte and embryo manipulation.

Conclusions:

• While variations in care exist, high-performing IVF programs attribute success to experienced personnel, consistent approaches, meticulous attention to detail, and effective communication.
• These factors are vital for achieving excellent outcomes in assisted reproduction.