Prospective mothers like Melika Dolaty are seeking crucial information about egg freezing success rates, only to be met with a frustrating lack of transparency from Canadian fertility clinics. Dolaty, a 33-year-old financial consultant from Toronto, expressed her desire to know the success rates, stating, “One hundred per cent that would help me so much to know the success rates. That’s a big deal for me.” Her attempts to find this data, including specific statistics for women of colour who may face unique challenges in fertility care, on the websites of several Toronto-area clinics proved unsuccessful.
Limited Public Reporting on Fertility Success
Unlike in the United States and the United Kingdom, Canadian fertility clinics are not mandated to publicly disclose their individual success rates. Kathleen Hammond, an associate professor at Toronto Metropolitan University’s law school specializing in health law, commented, “It doesn’t give anyone a real understanding of what their likelihood of success is at a particular clinic.” Egg freezing involves collecting and storing eggs for later use in achieving pregnancy. While the exact number of Canadian fertility clinics offering elective egg freezing is unknown, an investigation identified 42 clinics with 110 locations across seven provinces, predominantly privately owned.
For many of these clinics, reported data offers minimal insight into the likelihood of a successful birth. For instance, Tripod Fertility in Toronto advertises “over 600 babies born, a 4.4-star Google rating, and nearly a decade of experience,” highlighting its “personalized care and excellent outcomes.” However, the clinic’s website provides no specific statistics on its own fertility outcomes. Tripod Fertility did not respond to multiple requests for comment.
Industry Data and Patient Outcomes
The precise number of babies born in Canada between 2013 and 2023 from frozen eggs remains unconfirmed. Data from the Canadian Fertility and Andrology Society (CFAS), an industry association, indicates 70 births during this period from the 37 clinics that voluntarily submit data. Current estimates suggest only one percent of egg-freezing cycles in Canada have resulted in a live birth, largely because many individuals have not yet utilized or will never use their frozen eggs. Analysis of CFAS data reveals that only 25 percent of embryos created from frozen eggs and transferred into women have resulted in a live birth in Canada.
While CFAS publishes a national overview of fertility success rates based on data from most known clinics, its annual report does not detail individual clinic results. Emily McIntosh, CFAS executive director, stated that there is widespread support among member clinic owners for greater transparency regarding clinic-specific outcomes. Dr. Arthur Leader, an emeritus professor of obstetrics and gynecology at the University of Ottawa, who obtained some Ontario fertility clinic success rate data through a Freedom of Information request, noted a “wide variability” in outcomes between clinics. Anonymized data from 2019 showed live birth rates for women under 35 at Ontario fertility clinics ranging from less than 10 percent to over 60 percent.
Dr. Leader attributed these variations to factors such as physician skill and laboratory environments, but emphasized that without accessible data, patients are left in a “void.” He added, “People are being asked to judge the efficacy of a clinic by the waiting room, the clinical staff — the nurses, the sonographers, the psychologists — without really having any clue as to what goes on in the back room.”
International Precedents for Transparency
In contrast, the U.S., U.K., and Australia provide searchable birth-rate data for individual clinics. The U.S. Centers for Disease Control (CDC) publishes clinic-specific success rates in a searchable database, allowing filters for age and medical conditions. In the U.K., clinics are legally obligated to share patient outcome data, with a government database including the percentage of IVF treatments resulting in live births.
Defining ‘Success’ and Lack of Standardization
Hammond highlighted a distinct “lack of clarity” regarding how clinics define success. Some clinics promote their services based on general outcomes for the most fertile age groups. For example, Anova fertility chain in Ontario claims that “women between the ages of 30 and 37 have an 80 per cent chance of conceiving a child using frozen eggs,” without providing a source or specifying if this rate applies to their own clinic. Anova did not respond to requests for comment.
A number of clinics, such as Aurora in Saskatoon, do not publish data, citing challenges in interpreting IVF success rates due to variations in patient populations. They advise individuals to prioritize a “comfortable, convenient” clinic with a strong medical team. While clinics can apply for a CFAS compliance seal for standardized statistics, only three private clinics currently hold it: Ottawa Fertility Centre, Pacific Centre for Reproductive Medicine, and Olive Fertility in B.C. This seal indicates standardized presentation but allows success to be based on “clinical pregnancy,” which is an early sign of pregnancy and not a live birth.
In 2021, the U.K. government’s Human Fertilisation and Embryology Authority directed its clinics to be transparent about live birth rates. Some observers suggest that clinics may emphasize clinical pregnancy rates due to a potential lack of tracking of actual live birth statistics. Olive Fertility in Vancouver, which states it has “among the best pregnancy success rates in Canada,” did publish a study following 646 egg-freezing patients from 2013 to 2022. The study found that 65 patients thawed their eggs, leading to 23 successful embryo fertilizations and transfers. Fifteen patients, approximately one-quarter of those who thawed eggs and two percent of those who froze them, experienced “at least one delivery or ongoing pregnancy.” Olive Fertility did not respond to requests for comment.
Consent Forms and Regulatory Gaps
When asked to review consent forms, most clinics declined, stating they were only accessible to paying clients. OriginElle Fertility in Montreal was the only clinic to share its form, which was analyzed against a seven-point framework developed by Hammond. This framework recommends comprehensive information on the process, risks, financial obligations, and success rates. OriginElle’s document warned that eggs “may not survive the freezing, storage and thawing process” and might not be suitable for fertilization, but it lacked specific data on live birth rates and did not clarify that egg freezing is not a “guarantee” of having a baby.
Hammond has advocated for a standardized consent form template for all Canadian clinics to provide patients with adequate information on success rates and potential complications. Michel Dahan, a reproductive endocrinologist at OriginElle, expressed openness to a standardized framework but emphasized the crucial role of physician communication. “(Hammond) raises some very legitimate points,” Dahan stated. “I think it’s very important to address all those issues transparently to the patient. Whether it’s in the consent form or in a discussion with a patient really depends a lot on how you expect the patient to absorb (the information).”
Calls for Legislative Updates
The federal Assisted Human Reproduction Act, enacted in 2004, has not kept pace with the growth of egg freezing, according to experts. Health Canada communications advisor Karine LeBlanc indicated that the Act primarily allows regulation of the safety of donor sperm and ova. The CFAS has urged the federal government to update the Act and fund the national collection of data from all fertility clinics. McIntosh of CFAS noted, “There’s a lot of room for improvement. And I think we’re at this pivotal point in (the industry) where this is becoming a serious part of economic growth, social health, reproductive rights, equity. The public wants to know. And we want to be able to facilitate the information, to make sure that there’s trust in the care that’s being provided.”
Few provincial health ministries, with the exception of Quebec, mandate fertility centers to report success rates, including live births. In Ontario, while wait times are reported, success rate data collection is voluntary. Concerns have been raised within the industry that mandatory public reporting of live birth rates might lead clinics to refuse patients with lower chances of success to maintain favorable statistics. Dr. Leader dismissed this concern, pointing out that fertility clinics in the U.S., where success rate data is public, “continue to thrive.”
