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Obstetrics & Gynecology 2000;95:61-66
© 2000 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Recent Trends in Assisted Reproductive Techniques and Associated Outcomes

DANIEL W. CRAMER, MD, ScD, REBECCA F. LIBERMAN, MPH, DOUGLAS POWERS, PhD, MARK D. HORNSTEIN, MD, PATRICIA MCSHANE, MD and ROBERT L. BARBIERI, MD

From the Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, and Boston In Vitro Fertilization, Beth Israel-Deaconess Medical Center, Boston, Massachusetts; and the Reproductive Science Center of Boston, Deaconess-Waltham Hospital, Waltham, Massachusetts.

Address reprint requests to: Daniel W. Cramer, MD, ScD, Ob-Gyn Epidemiology Center, Brigham and Women’s Hospital, 221 Longwood Avenue, Boston, MA 02115 E-mail: dcramer{at}rics.bwh.harvard.edu

Objective: We examined recent trends in success rates for assisted reproduction and determined the influence of changes in patient selection and treatment characteristics on these trends.

Methods: We collected baseline information and abstracted treatment-related details and outcomes on 1244 couples accepted for in vitro fertilization (IVF) or gamete intrafallopian transfer (GIFT) at three clinics in greater Boston from 1994–1998.

Results: Delivery rates per initiated cycle improved significantly from 14.9% for IVF and 20.6% for GIFT in 1994–1995 to 22.5% for IVF and 28.0% for GIFT in 1997–1998 (P <= .001). After adjusting for female age, the two treatment-related variables that appeared most likely to explain this trend were decreased use of GnRH agonists in short course (flare) regimens and increased use of highly purified forms of urinary gonadotropins.

Conclusion: There were significant improvements in the success rates for IVF and GIFT from 1994–1998 that correlated with changes in ovulation induction regimens.




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