Impact on clinical outcomes of membership in the Society for Assisted Reproductive Technology.
Academic Article
Overview
abstract
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.
