Characterizing the Variability and Correlates of U.S. ART Clinic Performance During the COVID-19 Pandemic (2020-2022)

Abstract: Understanding the variability in Assisted Reproductive Technology (ART) clinic performance is crucial for patients and practitioners, particularly during periods of potential disruption such as the COVID-19 pandemic (2020-2022). This study aimed to characterize the year-to-year variability in key U.S. ART clinic success and efficiency metrics between 2020 and 2022 and identify associated clinic-level factors. Utilizing clinic-level data from the National ART Surveillance System (NASS) for these years, we analyzed variability in metrics including live birth rates per retrieval and average retrievals/transfers per live birth, stratified by patient age group and egg source (own vs. donor). Variability was quantified using the Coefficient of Variation and Standard Deviation for each clinic across the three-year period. Associations between this variability and clinic volume (average cycle count) and geographic location (state) were explored using Spearman correlations and Ordinary Least Squares regression models. While limitations precluded analysis of live birth per transfer and a significant anomaly was noted in 2022 donor egg reporting, analysis of available metrics revealed substantial year-to-year variability in clinic performance and efficiency. Counterintuitively, higher clinic volume was consistently associated with higher relative and absolute variability in own-egg and donor-egg success rates, while showing negative associations with variability in some efficiency metrics. Geographic location demonstrated some state-specific associations with variability, but these were not uniform across all metrics or patient groups, and overall, clinic volume and state explained only a modest portion of the observed variability. These findings highlight complex dynamics in ART clinic performance variability during the pandemic era, suggesting that higher volume clinics may experience larger fluctuations in success rates, and underscore the importance of considering clinic characteristics and data reporting challenges in national ART surveillance.

Subjects:	q-bio.TO; cs.LG
Cite as:	PX:2508.00051