Is your laboratory accredited?
Yes, by the College of American Pathologists.
How many embryologists do you have on staff?
(Embryologists work with eggs, sperm and embryos.) Our Fertility Center has seven experienced embryologists. Embryology requires a high level of skill to perform procedures meticulously and to develop and train in new protocols. Good staffing levels, like ours, allow us to do this work well and cover the lab 365 days a year. One embryologist for every 150 cycles performed is considered a good staffing level.
What is your laboratory staffing level on weekends?
We have a minimum of three staff doing procedures and monitoring incubators and cryofreezers on weekends.
How often do you monitor your alarm system?
Our on-site staff check our alarm system every single day, 365 days a year.
Do you have remote alarm monitoring?
Yes, our alarm system operates 24/7. If something were to go wrong with our liquid nitrogen tanks or incubators, we would receive an immediate alert and a staff member could be at the center quickly, ensuring the safety of all embryos.
Do you employ continuous undisturbed culture?
Yes. Embryos need to be observed regularly as they develop. But they also like peace and quiet, and to not be disturbed. We use a high-tech system that allows us to continuously monitor embryos without removing the dish from the incubator, thus minimizing stress.
How many incubators do you have?
(Embryos are grown in incubators under the watchful eye of embryologists) We have 16 incubators. While fertility centers vary in size, in general the more incubators they have the better. This reduces the need for sharing space with other patients’ embryos and provides a quieter environment.
Does your laboratory use low oxygen?
Yes. Using low levels of oxygen (much less than in normal air) in incubators has been proven to improve the viability of embryos and the chances of achieving pregnancy and birth.
What is your fertilization rate after ICSI (intracytoplasmic sperm injection, when a single sperm cell is injected directly into an egg)?
The benchmark for fertilization with ICSI in high-performing laboratories is 70 percent or higher. ICSI fertilization rates in our lab are between 80 and 90 percent. We are especially good working with severely impaired sperm.
Do you perform blastocyst-stage transfers for all patients?
Yes. There is good evidence that transferring embryos to the uterus at this stage (about day 5 or 6) improves the chances of pregnancy. Of course, the ability to grow embryos to the blastocyst stage is a challenge and once again an indicator of lab quality.
What is your embryo implantation rate?
Another key performance indicator is the implantation rate of a single transferred embryo. The implantation rate for our younger patients is 56 percent. This is well above the 2016 national average of 45.6 percent.
Does the in vitro fertilization (IVF) program promote single embryo transfers?
The goal is to have a single healthy baby at a time. If the laboratory has a high embryo implantation rate, the doctors will always promote doing single embryo transfers, especially in young patients. There is no need to risk the health complications for both mother and child that are associated with twin and triplet pregnancies.
What is your embryo survival rate after freezing?
We have excellent survival rates of 95 to 98 percent with frozen-thawed embryos. In fact we have reached the point where pregnancy and implantation rates with frozen embryos are as high as those with fresh transfers.
Finally, what is your live birth rate?
Cleveland Clinic Fertility Center’s live birth rate per transfer is 60 percent as compared to 49 percent in the 2016 national data.
*Performance benchmarks are based on outcomes of patients under age 35.
