How to assess quality of an IVF centre?

Few standards of quality are available to compare fertility centres with IVF programmes. We agree with authors who state 1⁄4``the use of pregnancy rates as a sole or most important criteria for the measure of quality in an IVF centre is misguided'' (Alper et al., 2002). Low pregnancy rates may indicate a poor laboratory performance, but may equally re ̄ect a high number of patients with poor prognosis. Otherwise, very high pregnancy rate per cycle may indicate that this centre has unacceptably high order multiple pregnancy rates and consequently high neonatal morbidity and mortality. ``Our product isn't a baby at any cost, our product is a service to help infertile couples manage their disorders'' (Alper et al., 2002). Not always are we successful. Not always do couples get a baby. In order to offer a good service, we should evaluate not only the pregnancy rate, but the procedures to be followed. Likewise the laboratory methods as well as the clinic aspects should be assessed. This requires that quali®ed and competent staff perform all procedures and that the methods used are reproducible. The subjective aspect of the quality of service in an IVF centre is patient satisfaction. It is less easy to measure and compare but it should not be neglected. We work at Procrearte (Reproductive and Molecular Medicine Network), which is integrated by 70 physicians all over our country, mainly in Buenos Aires. Our setting is a high technology IVF centre and we get in touch with our colleagues by means of our web site, (www.procrearte.com). Our IVF centre became accredited according to the requirements of SAEF (Argentinean Society of Fertility and Sterility) and Latin American Net on IVF. To maintain a high standard in our IVF laboratory and to assure reproducibility of the methods used we decided to apply for accreditation according to the norm ISO 9001/2000. A process was started where all routines and methods within the laboratory were documented and ®nally the quality control system was described in a manual. Application for accreditation was submitted to the Gruppo Registro Italiano Navale (RINA). Finally on November 6, 2002, our centre became accredited. Now Procrearte is the ®rst institution on Reproductive Medicine in Argentina accredited according to the ISO 9001/2000. We propose that ISO standards should be introduced to centres providing infertility services.