title: Establishment of comparative performance criteria for IVF centers: correlation of live birth rates in autologous and donor oocyte IVF cycles.
abstract: BACKGROUND
  To assess whether an objective performance criterion for in vitro fertilization (IVF) centers can be established.
  
  
  METHODS
  A retrospective analysis of 2011 National ART Surveillance System data for 451 U.S. IVF centers, 137 of which were included in the analysis since they performed >20 fresh embryo transfers per age group and >20 fresh oocyte donor transfers. The analysis of autologous cycles was restricted to women under age 40. The main outcome measure was correlation between center-specific live birth rates (LBR) in autologous and donor oocyte cycles.
  
  
  RESULTS
  55.6% donor and 46.7%, 39.1% and 28.7% (for ages <35, 35-37 and 38-40 years) autologous cycles resulted in live births per fresh embryo transfer. Donor LBR predicted autologous LBR (< 35 years, P < 0.001; 35 - 38 years, P < 0.001; 38 - 40 years, P = 0.015). Clinics with high prevalence of patients with diminished ovarian reserve had lower autologous LBR per age group (P = 0.015). Every 10% increase in donor LBR increased odds of autologous LBR above the age-adjusted national average by 68% (OR 1.68; 95% CI 1.36 - 2.07; P < 0.001).
  
  
  CONCLUSIONS
  Since center-specific donor and autologous IVF cycle outcomes correlate, and as donor cycles reflect fewer patient covariates, they represent a first comparable performance measure between centers, allowing for internal as well as external quality control.
authors.affiliation: The Center for Human Reproduction (CHR), 21 East 69th Street, New York, NY 10021, USA. vkushnir@thechr.com.
authors.forename: Vitaly A
authors.initials: VA
authors.lastname: Kushnir
authors.forename: Pallavi
authors.initials: P
authors.lastname: Khanna
authors.forename: David H
authors.initials: DH
authors.lastname: Barad
authors.forename: Norbert
authors.initials: N
authors.lastname: Gleicher
mesh_terms: D000328:Adult; D001723:Birth Rate; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D050498:Live Birth; D018587:Oocyte Donation / Q000592:standards / Q000706:statistics & numerical data; D009865:Oocytes / Q000166:cytology*; D011159:Population Surveillance / Q000379:methods; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011786:Quality Control; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies; D014019:Tissue Donors; D014481:United States