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Hum. Reprod. Advance Access originally published online on September 9, 2004
Human Reproduction 2004 19(11):2442-2444; doi:10.1093/humrep/deh501
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Human Reproduction vol. 19 no. 11 © European Society of Human Reproduction and Embryology 2004; all rights reserved

What is the most relevant standard of success in assisted reproduction?

The cumulated singleton/twin delivery rates per oocyte pick-up: the CUSIDERA and CUTWIDERA

Marc Germond1,2, Françoise Urner1, Alain Chanson1, Marie-Pierre Primi1, Daniel Wirthner1 and Alfred Senn1

1 Reproductive Medicine Unit, Department of Gynecology and Obstetrics, CHUV, 1011 Lausanne, Switzerland

2 To whom correspondence should be addressed. Email: marc.germond{at}chuv.hospvd.ch

National and international registries are essential tools for establishing new standards and comparing success rates, but they do not take into account the total pregnancy/delivery rate per oocyte recovery. In Switzerland and Germany, because of legal constraints, a maximum of three two-pronuclear zygotes are allocated for transfer whereas all the supernumerary pronuclear zygotes are immediately cryopreserved, preventing selection of the transferred embryos. We report on a 10 years' experience (1993–2002) of our centre which performs transfers of unselected embryos and cryopreservation at the two-pronuclear zygote stage. As ~30% of all deliveries are from cryo cycles, it is essential to take into account the contribution of the cryo transfers, and we propose therefore to evaluate, as a measure of IVF performance, the cumulated delivery rate per oocyte pick-up. This delivery rate is broken down further into the cumulated singleton delivery rate (CUSIDERA) and the cumulated twin delivery rate (CUTWIDERA). The sum (S) of these two rates is a measure of efficacy while the ratio CUTWIDERA/S as a percentage is a measure of safety of IVF treatments. Using these new indexes, the average 10 year efficacy and safety of our IVF programme were 26 and 19%, respectively. Both CUSIDERA and CUTWIDERA can be calculated easily in any clinical situation and yield useful parameters for patient counselling and internal/external benchmarking purposes.

Key words: cryopreservation/cumulated delivery rates/IVF/multiple pregnancies/treatment efficacy


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