Literature DB >> 10360901

Impact of the "physician factor" on pregnancy rates in a large assisted reproductive technology program: do too many cooks spoil the broth?

V C Karande1, R Morris, C Chapman, J Rinehart, N Gleicher.   

Abstract

OBJECTIVE: To determine whether in one program with unified treatment protocols, patients can expect varying treatment outcomes with different physicians.
DESIGN: Retrospective data analysis.
SETTING: University-affiliated infertility center with 14 physicians. PATIENT(S): One thousand eight hundred fifty IVF cycles performed consecutively between August 1995 and June 1997. INTERVENTION(S): The pregnancy rate and implantation rate per ET were evaluated for individual physicians between August 1995 and June 1996 (phase I). Physicians with lower success rates underwent strict supervision from July 1996 to June 1997 (phase II). MAIN OUTCOME MEASURE(S): Variations in success rates between physicians. RESULT(S): The pregnancy rate varied among the physicians from 13.2%-37.4%, and the implantation rate varied from 4.4%-14%. Some physicians' outcomes improved between phase I and phase II of the study, whereas others' did not. The pregnancy and implantation rates varied significantly for some physicians, depending on whether they were responsible for the choice of stimulation protocol, supervision of cycle monitoring, or ET in their own or other physicians' patients. CONCLUSION(S): Outcomes of IVF vary depending on the treating physician. Lower than expected pregnancy and implantation rates usually are not caused by poor ET techniques alone, but appear to be disproportionately the consequences of poor cycle stimulation.

Entities:  

Mesh:

Year:  1999        PMID: 10360901     DOI: 10.1016/s0015-0282(99)00139-9

Source DB:  PubMed          Journal:  Fertil Steril        ISSN: 0015-0282            Impact factor:   7.329


  14 in total

1.  Should a patient's own IVF physician perform the embryo transfer?

Authors:  Stephanie J Estes; Stacey A Missmer; Elizabeth S Ginsburg
Journal:  J Assist Reprod Genet       Date:  2006-05-24       Impact factor: 3.412

2.  Examination of bacterial contamination at the time of embryo transfer, and its impact on the IVF/pregnancy outcome.

Authors:  Helmy Selman; Monica Mariani; Nicoletta Barnocchi; Antonella Mencacci; Francesco Bistoni; Saverio Arena; Silvana Pizzasegale; Gian Francesco Brusco; Antonio Angelini
Journal:  J Assist Reprod Genet       Date:  2007-07-17       Impact factor: 3.412

3.  Role of embryo transfer in fellowship training.

Authors:  Michael D Wittenberger; William H Catherino; Alicia Y Armstrong
Journal:  Fertil Steril       Date:  2007-04-06       Impact factor: 7.329

4.  Impact of transabdominal ultrasound guidance on performance and outcome of transcervical uterine embryo transfer.

Authors:  Sebastian Mirkin; Estella L Jones; Jacob F Mayer; Laurel Stadtmauer; William E Gibbons; Sergio Oehninger
Journal:  J Assist Reprod Genet       Date:  2003-08       Impact factor: 3.412

5.  Factors affecting assisted reproductive technology (ART) pregnancy rates: a multivariate analysis.

Authors:  Tiffany L Rhodes; Thomas P McCoy; H Lee Higdon; William R Boone
Journal:  J Assist Reprod Genet       Date:  2005-10       Impact factor: 3.412

6.  Embryo transfer simulation improves pregnancy rates and decreases time to proficiency in Reproductive Endocrinology and Infertility fellow embryo transfers.

Authors:  Ryan J Heitmann; Micah J Hill; John M Csokmay; Justin Pilgrim; Alan H DeCherney; Shad Deering
Journal:  Fertil Steril       Date:  2017-03-11       Impact factor: 7.329

7.  Impact of physician performing embryo transfer on pregnancy rates in an assisted reproductive program.

Authors:  Antonio Angelini; Gian Francesco Brusco; Nicoletta Barnocchi; Imam El-Danasouri; Arianna Pacchiarotti; Helmy A Selman
Journal:  J Assist Reprod Genet       Date:  2006-09-17       Impact factor: 3.412

8.  Air bubble migration is a random event post embryo transfer.

Authors:  E Confino; J Zhang; F Risquez
Journal:  J Assist Reprod Genet       Date:  2007-04-13       Impact factor: 3.412

9.  Embryo afterloading: a refinement in embryo transfer technique that may increase clinical pregnancy.

Authors:  Adrienne B Neithardt; James H Segars; Sasha Hennessy; Aidita N James; Jeffrey L McKeeby
Journal:  Fertil Steril       Date:  2005-03       Impact factor: 7.329

10.  Training in embryo transfer: how should it be done?

Authors:  Lauren Bishop; Paul R Brezina; James Segars
Journal:  Fertil Steril       Date:  2013-05-10       Impact factor: 7.329

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