Redefining in vitro fertilization success: should triplets be considered failures?

OBJECTIVE: To evaluate how the ranking of IVF programs changes if high-order multiple pregnancies (HOMPs) are considered negative outcomes. DESIGN: Retrospective analysis. SETTING: The 2004 Society for Assisted Reproductive Technology Clinic Outcome Reporting System. PATIENT(S): Two hundred seven programs that performed >50 IVF cycles were analyzed, and only patients 2.4 embryos decreased, as opposed to the programs that transferred fewer embryos (1.8-2.4). CONCLUSION(S): Reclassifying HOMPs as failed cycles will result in a reduced rank in programs that maintain high embryo replacements. Redefining success as a singleton or twin birth significantly changes the ranking order of programs and, potentially, how programs are perceived.