The IVF league tables: time for a reality check.

In many countries the reported results of the different IVF clinics are published nationally by the relevant regulatory bodies, such as the Human Fertilisation and Embryology Authority in the UK. The published format suggests that clinics are being compared on a valid basis, and the involvement of the regulatory bodies apparently gives this comparison the official seal of authenticity. However, clinics can control many factors in patient selection, management and reporting, and these can inflate the reported results. Consequently, patients, instead of being appropriately guided, can be misled by these so-called "IVF league tables". The IVF community, including users, providers and regulatory bodies, need to recognize these factors and to develop a way forward for comparing clinics results on an equal and a valid basis. In this paper we discuss the factors that could affect the reported IVF results, and suggest possible options for valid comparison.