Variations in individual physician success rates within an in vitro fertilization program might be due to patient demographics

Objective To determine whether there are variations in individual physician success rates in an IVF program, even with uniform laboratory and treatment protocols. Design Retrospective analysis. Setting Boston IVF, a private practice. Patient(s) Patients <38 and 38-40 years of age who underwent non-donor egg, fresh embryo transfer (ET). Intervention(s) Retrospective analysis of IVF success rates for Boston IVF for the year 1999, as reported to the Society of Assisted Reproductive Technology. Main outcome measure(s) Each individual physician's clinical pregnancy and live birth rates for patients aged <38 and 38-40 years for the year 1999. Pregnancy rates were also obtained for an "ideal patient group." Result(s) Among 13 physicians, the clinical pregnancy rate in the <38-year age group ranged from 20.5% to 35.1% and the live birth rates from 17.8% to 31.1%. For the 38-40-year age group, the clinical pregnancy rate ranged from 10.6% to 29.8% and live birth rates from 7.0% to 25.5%. There was no statistical difference in the clinical pregnancy rate for the ideal patient group. Conclusion(s) In the ideal patient group, in which patient demographics are uniform, there are no statistical differences in individual physician performance within the same IVF program. Variation exists in the success rates between the physicians in the <38- and 38-40-year age groups. Possibly this is owing to patient demographics.