title: The impact of patient preselection on reported IVF outcomes.
abstract: We, in this manuscript, address the fact that increasing numbers of published studies in reproductive medicine selectively report outcomes for only favorably selected patients; while failing to note that, so reported outcome data,therefore, cannot be applied to unselected patient populations. Almost all favorable patient selection methods, starting with prolonged embryo culture to blastocyst stage, have, thus, been widely misrepresented in the literature since they almost universally report outcomes only in reference to embryo transfer. These outcome reports, however, do not include outcomes for poorer prognosis patients who do not reach embryo transfer. Study outcomes are universally applicable only if performed in unselected patient populations and reported with reference point cycle start (intent to treat). All other studies greatly exaggerate clinical pregnancy and live birth rates if applied to general populations, unless specifically noting that they can be extrapolated only to women who reach embryo transfer.
authors: The Center for Human Reproduction, 21 East 69th Street, New York, NY, 10021, USA. ngleicher@thechr.com.|The Foundation for Reproductive Medicine, New York, NY, USA. ngleicher@thechr.com.|The Rockefeller University, New York, NY, USA. ngleicher@thechr.com.
authors: Norbert
authors: N
authors: Gleicher
authors: The Center for Human Reproduction, 21 East 69th Street, New York, NY, 10021, USA.|Department of Obstetrics and Gynecology, Wake Forest University, Winston Salem, NC, USA.
authors: Vitaly A
authors: VA
authors: Kushnir
authors: The Center for Human Reproduction, 21 East 69th Street, New York, NY, 10021, USA.|The Foundation for Reproductive Medicine, New York, NY, USA.
authors: David H
authors: DH
authors: Barad
mesh_terms: D001723:Birth Rate; D001755:Blastocyst / Q000502:physiology; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D011247:Pregnancy; D018873:Pregnancy Rate; D011272:Pregnancy, Multiple; D019836:Preimplantation Diagnosis; D027724:Reproductive Techniques, Assisted
keywords: Blastocyst stage embryo culture; Embryo banking; In vitro fertilization (IVF); Outcome reporting; Patient selection biases; Preimplantation genetic screening (PGS)