Reporting assisted reproductive technology success rates on Australian and New Zealand fertility clinic websites

Background Fertility clinics commonly report their success rates online. These can be difficult to interpret as they are influenced by the way the data are presented. To improve transparency, the Reproductive Technology Accreditation Committee (RTAC) has published guidelines to support fertility clinics with their online reporting of success rates. However, it is unclear whether compliance with these guidelines will allow patients to make fair comparisons between clinics. Aims To illustrate the variability in patient and treatment populations that contribute to fertility clinic published rates. Materials and Methods Fertility clinics offering in vitro fertilisation treatment in Australia or New Zealand were assessed for compliance with six guidelines adapted from RTAC's code of practice, for reporting success rates in the public domain. All graphs and/or tables reporting clinic success rates were assessed to illustrate the combination of outcome or treatment variables contributing to each dataset. Results Twenty of the 30 fertility clinic websites reported success rates. Of these only 17 reported live births. The median compliance score with RTAC guidelines was 8/8 (interquartile range: 6-8). Of 41 figures published across all websites, five reported clinical pregnancy rates as their only outcome measure. Thirty-seven figures reported success rates 'per embryo transfer', two figures used 'per egg collection', and no figures described success rates 'per cycle started'. Thirty-two different combinations of reporting variables were observed. Conclusions Websites were broadly compliant with RTAC's guidelines. However, considering the variability in patient and treatment groups contributing to success rate data, patients cannot be expected to make an informed decision based on clinics' self-reported outcomes. RTAC guidelines could be improved by providing a clear definition of success, including the appropriate use of denominators.