My husband is 47 and has had a vasectomy. I am 37 and have never been pregnant. We are interested in nonsurgical sperm aspiration and ICSI, so I have been researching IVF centers. Where can I get success rate information or advice on finding a center that would be appropriate for our needs? I feel a team approach center is my best choice, since both of us need assistance.

Jasmine

As an IVF physician, I can best advise you on how our program works and how we manage patients. First, I do not believe that IVF success rates are the best way to shop for your care. IVF is a competitive business, with large corporations owning many IVF centers. Pressures exist to provide the highest success rates. Unfortunately it is very easy to manipulate success rates.

Consider two examples. In the first, Dr. Help-All ignores the numbers and provides patients with accurate information on their chance of success. Many women whose odds for success are low will still attempt IVF, hoping they will beat the odds. Dr. H-A is willing to accept these patients, so success rates at Dr. H-A's program are relatively low. By comparison, Dr. Look-Good wants to advertise the highest success rates in town. So, Dr. L-G tells patients who are not likely to succeed that they are not candidates for IVF. Meanwhile, Dr. L-G advises women who have the greatest likelihood of success to go ahead. Dr. L-G's success rate looks great because that program gets the easiest cases.

You can visit the American Society of Reproductive Medicine site to learn more about the clinic-specific reporting program.