Journal of Assisted Reproduction and Genetics

, Volume 33, Issue 4, pp 455–459 | Cite as

The impact of patient preselection on reported IVF outcomes

  • Norbert Gleicher
  • Vitaly A. Kushnir
  • David H. Barad


We, in this manuscript, address the fact that increasing numbers of published studies in reproductive medicine selectively report outcomes for only favorably selected patients; while failing to note that, so reported outcome data,therefore, cannot be applied to unselected patient populations. Almost all favorablepatient selection methods, starting with prolonged embryo culture to blastocyst stage, have, thus, been widely misrepresented in the literature since they almost universally report outcomes only in reference to embryo transfer. These outcome reports, however, do not include outcomes for poorer prognosis patients who do not reach embryo transfer. Study outcomes are universally applicable only if performed in unselected patient populations and reported with reference point cycle start (intent to treat). All other studies greatly exaggerate clinical pregnancy and live birth rates if applied to general populations, unless specifically noting that they can be extrapolated only to women who reach embryo transfer.


In vitro fertilization (IVF) Patient selection biases Outcome reporting Blastocyst stage embryo culture Preimplantation genetic screening (PGS) Embryo banking 


Compliance with ethical standards

Conflict statement

None of the authors perceive any potential conflicts in respect to here presented manuscript. N.G, and D.H.B, are co-inventors on a number of pending and already awarded U.S. patents claiming therapeutic benefits from androgen supplementation in women with low functional ovarian reserve (LFOR) and relating to the FMR1 gene in a diagnostic function in female fertility. Both receive royalties from Fertility Nutraceuticals, LLC, in which N.G. also holds shares. N.G., D.H.B and V.A.K. also are co-inventors on a pending AMH-related patent application. They report no other potential conflicts with here reported manuscript.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Norbert Gleicher
    • 1
    • 2
    • 3
  • Vitaly A. Kushnir
    • 1
    • 4
  • David H. Barad
    • 1
    • 2
  1. 1.The Center for Human ReproductionNew YorkUSA
  2. 2.The Foundation for Reproductive MedicineNew YorkUSA
  3. 3.The Rockefeller UniversityNew YorkUSA
  4. 4.Department of Obstetrics and GynecologyWake Forest UniversityWinston SalemUSA

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