Comparative clinical outcomes of SART versus non-SART clinics.
Academic Article
Overview
abstract
OBJECTIVE: Comparing attributes and clinical outcomes of clinics affiliated with the Society for Assisted Reproductive Technology (SART) to those not affiliated. DESIGN: Observational cross-sectional study of SART and non-SART member clinics utilizing Center for Disease Control (CDC) data from 2021 SUBJECTS: Aggregate clinic summaries from all United States (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 (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 CDC, and 9.4% did not report at all (a violation of federal law). SART clinics had higher live birth rates (LBR) per retrieval than non-SART clinics across all age groups (age <35: 54.87% versus 45.7%, age 35-37: 40.82% versus 34.59%, age 38-40: 26.14% versus 20.45%, age >40: 10.38% versus 6.02%). SART clinics also had higher LBR of singleton, term, normal-weight infants than non-SART clinics (age <35: 42.47% versus 29.54%, age 35-37: 31.71% versus 25.11%, age 38-40: 21.28% versus 15.74%, age >40: 8.11% versus 4.05%). In addition, rates of multifetal gestation and miscarriage were lower in SART clinics compared to non-SART clinics across all age groups. CONCLUSION: SART clinics demonstrated better ART clinical outcomes compared to non-SART clinics, likely due to enhanced regulatory oversight, including: 1. Higher live birth rates when compared per cycle start, per oocyte retrieval, and per embryo transfer, 2. Higher rates of singleton, full-term live births of normal-weight infants, 3. Lower rates of multifetal delivery, and 4. Lower rates of miscarriage.
