Articles
Register for Regional Clinical Practice Patterns in Reproductive
Endocrinology:
A Collaborative Transnational Pilot Survey of In vitro Fertilization Programs in
the Middle East
E. S. Sills, H. S. Qublan, Z. Blumenfeld, A. V. T. Dizaj,
A. Revel, S. Coskun, I. A. Jaoude, G. Serour, M. Eskandar,
M. Ali Khalili, A. Demirol, K. Trokoudes, P. Ocal, A. M. Sultan, B. A. Lotto &
Ad. El-Kareh
Journal of Experimental & Clinical Assisted Reproduction 2007
An
Open
Access Research article
Published by BioMed Central
Published 28 August 2007
Abstract (provisional)
Background
This research describes current clinical and demographic
features sampled from reproductive endocrinology programs currently offering in
vitro fertilization (IVF) in the Middle East. Methods: Clinic leadership
provided data via questionnaire on patient demographics, demand for IVF
services, annual cycle volume, indications for IVF, number of embryos
transferred, twinning frequency, local regulations governing range of available
adjunct therapies, time interval between initial enrollment and beginning IVF as
well as information about other aspects of IVF at each center. Results: Data
were received from representative IVF clinics (n=13) in Cyprus, Egypt, Iran,
Israel, Jordan, Lebanon, Qatar, Saudi Arabia and Turkey. Mean (+/-SD) age of
respondents was 47.8+/-8yrs, with average tenure at their facility of
11.2+/-6yrs. Estimated total number of IVF programs in each nation responding
ranged from 1 to 91. All respondents reported individual participation in
accredited CME activity within 24months. 76.9% performed embryo transfers
personally; blastocyst transfer was available at 84.6% of centers. PGD was
offered at all sites. In this population, male factor infertility accounted for
most IVF consultations and the majority (59.1%) of female IVF patients were
<35yrs of age. Prevalence of smoking among female IVF patients was 7.2%. Average
number of embryos transferred was 2.4 (+/-0.4) for patients at age <35yrs, and
2.9 (+/-0.8) at age >41yrs. For these age categories, twinning (any type) was
observed in 22.6 (+/-10.8)% and 13.7 (+/-10.4)%, respectively. In 2005, the
average number of IVF cycles completed at study sites was 1194 (range 363-3500)
and 1266 (range 263-4000) in 2006. Frozen embryo transfers accounted for 17.2%
of cycles at these centers in 2005. Average interval between initial enrollment
and IVF cycle start was 8 weeks (range 0.3-3.5 months). Conclusion: This
sampling of diverse IVF clinics in the Middle East, believed to be the first of
its kind, identified several common factors. Government registry or oversight of
clinical IVF practice was limited or nonexistent in most countries, yet number
of embryos transferred was nevertheless fairly uniform. Sophisticated
reproductive health services in this region are associated with minimal delay
(often <8 weeks) from initial presentation to IVF cycle start. Most Middle East
nations do not maintain a comprehensive IVF database, and there is no
independent agency to collect transnational data on IVF clinics. Our pilot study
demonstrates that IVF programs in the Middle East could contribute voluntarily
to collaborative network efforts to share clinical data, improve quality of
care, and increase patient access to reproductive services in the region.
The complete article is available as a
provisional PDF. The fully formatted PDF
and HTML versions are in production.
Journal of Experimental & Clinical Assisted Reproduction 2007,
4:3 doi:10.1186/1743-1050-4-3
