Análisis de los indicadores de calidad entre los diferentes centros públicos españoles en técnicas de reproducción asistida; benchmarking

Abstract

IntroductionPublic centers with IVF/ICSI laboratory (In Vitro Fertilization/Intracytoplasmic Sperm Injection) must guarantee both the efficacy and safety of treatment in patients. Benchmarking offers us a vision of where we should direct our efforts in this regard. The objective of this work is to identify if the procedures carried out by national public centers are effective and safe. Material and methodsBased on the National Activity Registry - Spanish Fertility Society Registry and an online survey, data on results, clinical practice and physical and human resources were obtained from 42 public centers that are included in its IVF/ICSI service portfolio. The results were compared with the specification at the desirable level of the quality indicators of UNE 179007:2013 (Quality Management Systems for Assisted Reproduction Laboratories) established by the Association for the Study of Reproduction Biology (ASEBIR). Those of greater efficiency and safety were defined and identified as ‘excellent’ centers, in order to carry out a benchmarking study. ResultsThe average of the quality indicators analyzed in public centers, reached and/or exceeded the ASEBIR quality specifications at the desirable level. Two centers were considered ‘excellent’ for presenting a higher gestation rate with a low percentage of multiple gestations. These centers had a percentage of contraceptive cycle programming, embryonic transfer in blastocyst, deferred transfer, elective transfer of single embryo and percentage of cycles with conventional IVF versus ICSI higher than the average of public centers. Evaluating the human, physical resources and the weekly activity, no relation was obtained with better results. ConclusionsExcellence in Public Centers is related more to a set of procedures than to a single one.