Objective

To evaluate similarities and differences in clinical and laboratory practices among high-performing fertility clinics.

Design

Cross-sectional questionnaire study of selected programs.

Setting

Academic and private fertility practices performing in vitro fertilization (IVF).

Patient(s)

Not applicable.

Intervention(s)

A comprehensive survey was conducted of 13 IVF programs performing at least 100 cycles a year and having high cumulative singleton delivery rates for 2 years.

Main Outcome Measure(s)

Clinical and laboratory IVF practices.

Result(s)

Although many areas of clinical practice varied among top programs, some commonalities were observed. All programs used a combination of follicle-stimulating hormone and luteinizing hormone for IVF stimulation, intramuscular progesterone in frozen embryo transfer cycles, ultrasound-guided embryo transfers, and a required semen analysis before starting the IVF cycle. Common laboratory practices included vitrification of embryos at the blastocyst stage, air quality control with positive air pressure and high-efficiency particulate air filtration, use of incubator gas filters, working on heated microscope stages, and incubating embryos in a low-oxygen environment, most often in benchtop incubators.

Conclusion(s)

Some areas of consistency in clinical and laboratory practices were noted among high-performing IVF programs that are likely contributing to their success. High-performing programs focused on singleton deliveries. As the field of IVF is rapidly evolving, it is imperative that we share best practices in an effort to improve outcomes from all clinics for the good of our patients.

中文翻译：

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美国始终如一的高性能体外受精计划的常见做法：10 年更新

客观的

评估高性能生育诊所之间临床和实验室实践的异同。

设计

选定项目的横断面问卷调查研究。

环境

进行体外受精 (IVF) 的学术和私人生育实践。

病人）

不适用。

干预措施

对 13 个 IVF 项目进行了全面调查，这些项目每年执行至少 100 个周期，并且在 2 年内具有高累积单胎分娩率。

主要观察指标）

临床和实验室 IVF 实践。

结果）

尽管临床实践的许多领域因顶级项目而异，但还是观察到了一些共性。所有项目都使用卵泡刺激素和黄体生成素的组合来进行 IVF 刺激、冷冻胚胎移植周期中的肌肉注射黄体酮、超声引导的胚胎移植以及开始 IVF 周期之前所需的精液分析。常见的实验室实践包括囊胚期胚胎玻璃化、通过正气压和高效微粒空气过滤进行空气质量控制、使用培养箱气体过滤器、在加热显微镜台上工作以及在低氧环境中孵育胚胎，大多数通常在台式培养箱中。

结论

在可能有助于其成功的高性能 IVF 计划中，注意到临床和实验室实践的一些一致性领域。专注于单例交付的高性能程序。随着 IVF 领域的快速发展，我们必须分享最佳实践，努力改善所有诊所的结果，造福于我们的患者。