BMJ 1998;317:1593 ( 5 December )

Letters

League tables of in vitro fertilisation clinics misinform patients

The first 150 words of the full text of this article appear below.

EDITORMarshall and Spiegelhalter have done a valuable service in questioning the reliability of the Human Fertilisation and Embryology Authority's league tables of in vitro fertilisation clinics.¹ Unfortunately, the tables are probably even less reliable than these authors suggest.

The authority reports adjusted life birth rates, which are based mostly on the female patient's age. As the method of adjustment is unpublished one cannot judge whether the various factors are weighted correctly. Moreover, this adjustment does not embody all factors affecting outcome. These include an accurate record of the number of previous cycles of in vitro fertilisation, basal follicle stimulating hormone concentrations, amount of gonadotrophin needed before eggs are collected, total ovarian response, and number of embryos transferred. Some clinics attempt to reduce the incidence of triplet pregnancy by transferring only two embryos except where prognosis is known to be poor. Others try to increase success, but also increase . . . [Full text of this article]

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