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Impact on clinical outcomes of membership in the Society for Assisted Reproductive Technology
Daniela Diego1, Ilissa Pipia2, Ariana Traub3
1Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Emory University, Atlanta, Georgia.
Objective:
To compare attributes and clinical outcomes of clinics affiliated with the Society for Assisted Reproductive Technology (SART) with those not affiliated.
Design:
Observational cross-sectional study of SART and non-SART member clinics using Centers for Disease Control and Prevention data from 2021.
Subjects:
Aggregate clinic summaries from all US assisted reproductive technology (ART) clinics.
Exposure:
None.
Main Outcome Measures:
Oversight mechanisms and pregnancy outcomes of SART and non-SART clinics were compared. Specifically, live birth rates (LBRs) (per intended retrieval, completed retrieval, and first embryo transfer), singleton, term, normal-weight deliveries (per intended retrieval, completed retrieval, and first embryo transfer), and multifetal and miscarriage rates in SART and non-SART clinics were compared.
Results:
Of the 496 US ART clinics in 2021, 72.8% were SART members. Among the non-SART clinics, 17.7% reported directly to the Centers for Disease Control and Prevention, and 9.4% did not report at all (a violation of federal law). The SART clinics had higher LBRs per retrieval than non-SART clinics across all age groups (age of <35 years, 54.87% vs. 45.7% age of 35-37 years, 40.82% vs. 34.59%; age of 38-40 years, 26.14% vs. 20.45%; age of >40 years, 10.38% vs. 6.02%). The SART clinics also had higher LBRs of singleton, term, normal-weight infants than non-SART clinics (age of <35 years, 42.47% vs. 29.54%; age of 35-37 years, 31.71% vs. 25.11%; age of 38-40 years, 21.28% vs. 15.74%; age of >40 years, 8.11% vs. 4.05%). In addition, rates of multifetal gestation and miscarriage were lower in SART clinics than in non-SART clinics across all age groups.
Conclusion:
The SART clinics demonstrated better ART clinical outcomes than non-SART clinics, likely due to enhanced regulatory oversight, including the following: higher LBRs when compared per cycle start, per oocyte retrieval, and per embryo transfer; higher rates of singleton, full-term live births of normal-weight infants; lower rates of multifetal delivery; and lower rates of miscarriage.
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