IVF Quality

• Live birth rates per successful egg retrieval: 49.7% (under 35), 36.3% (35-37), 23.1% (38-40) — within Score 4 range, approaching Score 5
• Single embryo transfer rate: 73.9% in 2022 (Score 4 range of 60-80%)
• Laboratory accreditation: 88% of U.S. labs have CAP accreditation, representing ~402 accredited clinics far exceeding the 5+ clinics required for Score 5
• Comprehensive national surveillance: NASS captures 98% of all ART cycles with mandatory outcome reporting required by the Fertility Clinic Success Rate and Certification Act of 1992
• Physician training: Reproductive endocrinologists complete 15+ years of education including 4 years medical school, 4-year OB/GYN residency, and 3-year REI fellowship with board certification
• OHSS safety: Less than 5% of women undergoing IVF experience OHSS, with severe cases occurring in less than 1%

Read the full United States report →

• SEF national registry: 34-35% clinical pregnancy per transfer for women under 40; 90% single embryo transfer rate in blastocyst cycles; 50% clinical pregnancy rate with fresh embryos nationally
• Dexeus Mujer: dual ESHRE accreditation (clinical/laboratory practice + subspecialist training); Instituto Bernabeu: 63.8% positive pregnancy test for women under 35; Institut Marquès: 83.2% live birth rate for donor-egg IVF under 35
• ESHRE 2019 delivery rate: 16.4% per fresh aspiration cycle; twin delivery rate 11.0% vs European average 11.9%, indicating safe stimulation protocols
• Research contributions: IVIRMA presented 37 studies at ASRM 2023; Instituto Bernabeu received ASEBIR national research award three times; 2025 analysis found transparency gap—only 1 of 5 clinics reviewed reported live birth rates publicly

Read the full Spain report →

• Single embryo transfer rate 88% (exceeds Score 5 threshold of 80%) with multiple birth rate of 3.4%, one of the lowest globally
• Severe OHSS <0.1% of cycles, far below 3% threshold, with robust British Fertility Society 2024 prevention guidelines
• All 107 fertility treatment clinics HFEA-licensed with biennial inspections, transparent clinic-specific outcome reporting by age group, and publicly searchable success rates; HFEA Register is world's longest-running ART database since 1991
• RCOG Reproductive Medicine subspecialty training requires MD/PhD plus MRCOG with seven years specialist training; embryologists require HCPC registration via NSHCS Scientist Training Programme
• ISO 17025:2017 and ISO 9001:2015 laboratory accreditation; ARCS Good Practice in Clinical Embryology Guidelines 2024 implemented across sector
• Cumulative live birth rates of 65–68% for under-35s across three cycles (Score 5 level); national live birth rate per fresh embryo transferred 35% under-35, 26% for 35–37, 18% for 38–39 reflects deliberate SET prioritization rather than poor quality

Read the full United Kingdom report →

• FET live birth rate 28.8% per transfer in 2023; cumulative rate 58.4% for women under 35 over 6 cycles (Assisted Reproductive Technology in Japan 2023 - JSOG)
• SET rates 80.5% (fresh) and 84.7% (FET) among the highest globally, with singleton live birth rates above 96% (Assisted Reproductive Technology in Japan 2023 - JSOG)
• OHSS rate below 1% in large Japanese cohorts, significantly below the 3% threshold (Individualized Follitropin Delta Dosing - PubMed 2021)
• 31 JISART-accredited clinics with ISO 9001 certification and triennial 245-point audits covering 245 quality criteria (Audit and Accreditation of ART Facilities in Japan - JISART 2022)
• JSOG national registry with 98% facility participation (625 of 638 clinics) since 1986, with mandatory annual reporting (Assisted Reproductive Technology in Japan 2023 - JSOG)
• Ranked top 5 globally for ICSI research contribution; evidence-based treatment protocols with 59.8% freeze-all adoption (Bibliometric Analysis of ICSI Research - PMC 2023)

Read the full Japan report →

• Leading fertility clinics report pregnancy success rates of 50-60% per embryo transfer, significantly exceeding the global average and meeting Score 5 thresholds for women under 35
• OHSS incidence of 5.4% in fresh embryo transfers (2017-2022 national data) exceeds the <3% benchmark for Score 5 but falls within the 3-5% acceptable range for Score 4
• Comprehensive national IVF registry established in 2018, collecting data from 201 certified institutions with national insurance coverage since 2017
• CHA Fertility Center certified by South Korean Ministry of Health and Welfare for 120 safe therapy standards (only facility among 368 with this certification), plus JCI-accredited centers, though specific count of 5+ JCI clinics not documented
• Board-certified reproductive endocrinologists with subspecialty training, including 17 board-certified specialists at major CHA center, supporting professional standards

Read the full South Korea report →

• Eight RTAC-accredited fertility clinics—the highest concentration outside Australia and New Zealand—indicating exceptional third-party validation of laboratory and clinical quality
• Live birth rates approximately 46% for women under 35, aligned with Cleveland Clinic benchmarks but below the >50% threshold for Score 5
• Clinical specialists with FRCOG/MRCOG qualifications and 15–25+ years of fertility experience; average specialist training exceeds 20 years at leading clinics
• No national IVF registry exists; all published success rates are clinic self-reported without independent verification, creating transparency gaps for international patients
• Mean single embryo transfer rate of 2.0 per cycle at leading clinics; no national SET mandate despite evidence-based momentum toward SET practices
• Laboratory technology including NGS preimplantation genetic testing, time-lapse embryo monitoring, vitrification with 90–100% post-thaw survival, and IMSI sperm selection

Read the full Malaysia report →

• Klinika Bocian reports 62% live birth rate for women under 35 and 47% for ages 35-40, meeting Score 5 thresholds at elite level [IVF Success Rate in Poland: the Best Clinic - Klinika Bocian - 2025]
• Gameta is the first ESHRE-certified fertility clinic in all of Europe; Invicta holds ISO 15189, ISO 9001, ISO 14001 accreditations [About Gameta / Effective IVF treatment in Poland - 2024]
• National OHSS rate of 0.34% (2013-2016) is exceptionally low, well below the 3% Score 5 threshold, indicating excellent safety protocols [Assisted reproductive medicine in Poland, 2013-2016 - PTMRiE/SPiN PTGiP - 2021]
• Single embryo transfer rate of 66.9% (2019) falls squarely in Score 4 range (60-80%) and reduces multiple birth risks [ART in Europe, 2019 - ESHRE - PMC - 2023]
• PTMRiE explicitly noted absence of centralized national ART database prevents fully reliable assessment of treatment quality; mandatory comprehensive national registry is a Score 5 requirement [Assisted reproductive medicine in Poland, 2013-2016 - PubMed - 2021]

Read the full Poland report →

• Leading clinics report 40–50% live birth rates per cycle for women under 35 (Nova IVF, Indira IVF); national average 30–40% across all registered centers
• Only 2–3 internationally accredited fertility centers: BirthRight by Rainbow Hospitals (JCI), Apollo Fertility Bengaluru (JCI/QAI), Yellow Fertility Gurgaon (NABH accreditation 2024)
• Single embryo transfer rates approximately 10–12% at leading clinics and historically 10% nationally, versus 60–80% benchmark for Score 4
• No publicly available comprehensive national IVF outcome registry; last formal NARI publication covered 2007–2009 data; mandatory registry under 2021 ART Act has not published comparative outcome data as of mid-2025
• Qualified specialist cadre: FNB Reproductive Medicine (2-year post-doctoral, ~7–8 competitive seats nationally); ISAR 7,500+ members; leading specialists participate in ESHRE and ASRM; Indian contributions to ICMART global ART dataset

Read the full India report →

• Population-level live birth rates (Maccabi 67,059 cycles): 24–27% for women <35, 16% for ages 35–39, below Score 4 thresholds of 40–50% and 30–40%
• 5+ JCI-accredited fertility centers (Assuta, Sheba, Sourasky, Hadassah, Rambam) with international quality benchmarking
• Faculty-level specialists: Prof. Foad Azem (40 years, 4,000+ successful pregnancies), Prof. Alexander Simon (43 years, 5,000+ procedures)
• Single embryo transfer rate estimated <40%, well below Score 4 requirement of 60–80%; mean 1.2 live births per delivery indicates high multiple-pregnancy rates
• State Comptroller (Nov 2024) declared IVF oversight a 'fundamental failure'; deficiencies from 2018–2019 unresolved prior to Sept 2022 embryo mix-up at Assuta Rishon LeZion
• Advanced laboratory technology (Embryoscope time-lapse, AI embryo scoring) at flagship centers; innovation leadership (AIVF: 38% accuracy improvement; QART Medical: 34%→65% pregnancy rate in trials)
• No comprehensive national IVF outcomes registry; success rates largely self-reported by individual clinics using varying methodologies

Read the full Israel report →

• 58 REDLARA-accredited centers (38.1% of all REDLARA sites globally) demonstrating significant international quality recognition
• REDLARA registry delivery rates of ~24% per fresh embryo transfer and ~30% per frozen embryo transfer (2019 data with Brazil contributing 46% of cycles)
• Single embryo transfer rate of only 38.3% producing twin rates of 26%, far exceeding 5-10% ESHRE/ASRM targets—a major quality concern
• Zero of 161 Brazilian fertility clinics publish live birth rates; only 33.5% publish any success rate metrics—critical transparency failure
• Human reproduction recognized as formal FEBRASGO subspecialty with board certification (TEGO); leading clinics operate 25-35 years with substantial experience
• Mandatory SisEmbrio registry requires all 193+ clinics to report cycle volumes and embryo production; ANVISA laboratory regulation (RDC 33/23) and CFM 2294/21 embryo transfer limits provide institutional oversight

Read the full Brazil report →

• InSer holds JCI, AAAASF, GHA (renewed 2024), and REDLARA accreditation; Reprotec holds ISO 9001 (unique in Colombia) and ESHRE/ASRM membership — 2–3 clinics with strong international accreditation, below the 5+ required for Score 5
• Reported success rates at leading clinics range 40–65% clinical pregnancy per cycle; Babynova estimates ~40% under 35, 25–30% ages 35–39, and 10–15% over 40, but these are clinical pregnancy rates and live birth rate data by age group are not published
• No mandatory national ART outcome registry exists; only 14 of ~50 Colombian fertility clinics report to REDLARA voluntarily, creating a transparency gap where the majority operate without publicly available outcome data
• No published national data on SET %, multiple birth rates, or OHSS rates; regional REDLARA data (2019) show 26.4% twin rate in Latin America, suggesting SET adoption lags significantly behind international benchmarks
• CECOLFES's research contributions (first IVF live birth in Latin America 1985, pioneering stem cell work) demonstrate scientific capacity, and leading specialists have international training, but regulatory framework remains weak (Decree 1546/1998 not updated; Law 1953/2019 implementation incomplete)
• Report explicitly identifies 'the absence of a mandatory national IVF outcome registry' as 'the most significant structural concern for medical tourists,' indicating that regulatory environment does not uniformly protect patients outside accredited centers

Read the full Colombia report →

• Live birth rates: 22.5% per fresh embryo transfer nationally (2022); 30.9% for women aged 30-34; cumulative >80% pregnancy within 4 cycles for women under 34
• Laboratory quality: ISO 15189 accreditation via DAkkS; ESHRE ART Centre Certification; time-lapse embryoscopy and ICSI capabilities at major centers
• Clinical expertise: Bundesärztekammer-supervised subspecialty training; AGRBM requires ≥6 years experience or ESHRE Senior Embryologist qualification; Germany ranks 5th in European ART research output
• Single embryo transfer trend: Dramatic improvement from 34.4% SET rate in 2019 to multiple birth rate of 8% overall in 2023, breaking the 10% threshold for first time
• Outcome transparency limitation: D·I·R provides aggregate national data only; individual clinic success rates not publicly disclosed; 15.1% of outcomes from reporting centers undocumented (2014 audit)

Read the full Germany report →

• Independent peer-reviewed study found 14.1% live birth rate from 2,059 ICSI cycles, below Score 3 minimum for most age groups
• Multiple-birth rates of 22.7% twins and 4.5% triplets indicate <40% single embryo transfer rate (explicit red flag in rubric)
• Jordan Hospital and Jordan University Hospital hold JCI accreditation, but only 2 out of ~14 IVF facilities have documented international accreditation
• Prof. Khaldoun Sharif (FRCOG, FACOG, 100+ publications, former Birmingham Women's Hospital Clinical Director) represents world-class specialist leadership comparable to Score 5, but is not representative of the sector overall
• No mandatory national ART registry or success-rate reporting requirement; clinics self-certify outcomes; large discrepancy between self-reported rates (57% <35) and verified rates (14.1% overall)

Read the full Jordan report →

• Live birth rates of 40-50% for women under 35, competitive with Score 4 threshold, but with reliability concerns due to transparency issues
• Single embryo transfer rate of only 3.11% with 20.78% twin and 0.92% triplet rates, indicating suboptimal embryo transfer practices and elevated patient safety risks
• Only 1-2 fertility-specific JCI-accredited clinics, falling below Score 4 requirement of 2-4 JCI clinics
• OHSS rates of 6.7% in conventional IVF exceed international standards of <5%, aligning with Score 3 range (5-8%)
• Mandatory national IVF registry absent; REDLARA participation is voluntary with only 50-60% of all ART centers reporting
• Documented massive discrepancy: clinics advertise 60-96% success rates while independent field study found actual 21.9% pregnancy rate and 10.8% live birth rate per cycle
• Voluntary specialty certification in reproductive medicine creates inconsistent training standards, with CONACEM certification optional rather than mandatory

Read the full Mexico report →

• Clinical pregnancy rates 31.6-43.9% for fresh embryo transfers with fresh cycle success at 30.6%, within Score 3 range of 30-40% for women under 35
• Exceptional safety record with >99.6% of IVF cycles completed without serious OHSS complications (<0.4% rate), far exceeding international benchmarks
• Extensive international accreditation with 50+ JCI-accredited hospitals and ISO-certified facilities, exceeding Good threshold requirements
• Lack of publicly accessible national IVF registry; success rates submitted to Ministry of Health but not available publicly, with reporting to European registries stopped after 2012
• Mandatory 6-month Ministry of Health-approved training for IVF physicians with regular 6-monthly inspections, though training period is shorter than 3-year fellowship requirements in leading countries

Read the full Turkey report →

• Live birth rates 23.6% overall in 2023, down from 19% in 2019 and 16% in 2021—well below EU average of 33%
• Only one clinic with international accreditation: Versys Clinics holding ESHRE ART Centre Certification for Good Practice (one of ~4 globally), but largely inaccessible to foreign patients post-July 2022 nationalization
• No ESHRE-accredited subspecialist training centers in Hungary; general gynecologists with fertility training or emerging specialists dominate
• Multiple pregnancy rate of 12.5% in 2023 indicates partial compliance with single embryo transfer mandates; above sub-10% international best practice
• New mandatory national ART registry introduced 2023 but first comprehensive report not expected until 2026; outcome data historically incomplete

Read the full Hungary report →