A retrospective comparison of the impact of industry payments on assisted reproductive technology practice and outcomes.

Objective: To determine whether industry payments to physicians are associated with a difference in assisted reproductive technology practices and outcomes.

Design: Retrospective cohort.

Patient(s): Patients undergoing asissted reproduction.

Intervention(s): Industry payments reported to the Open Payments 2020 database.

Main Outcome Measure(s): The live birth rate, frozen embryo transfer (FET) rate, intracytoplasmic sperm injection (ICSI) rate, preimplantation genetic testing (PGT) rate, and percentage of patients aged >40 years were obtained from the Centers for Disease Control and Prevention 2020 database. Linear regression analysis was performed comparing the percentage of physicians per center receiving industry payments to clinic-level outcomes.

Result(s): A total of 873 reproductive endocrinology and infertility physicians received payments in the 2020 database. At least one physician received a payment in 80.5% (437/543) of in vitro fertilization centers. Of 1,724 reproductive endocrinology and infertility physicians, 873 (50.6%) received at least one payment in 2020. The live birth, ICSI, FET, and PGT rates and percentage of patients aged >40 years did not significantly differ between centers by percentage of physicians receiving industry payments. However, in the subanalysis of 99 large centers (defined as ≥5 physicians), each increase in the percentage of physicians receiving industry payments was associated with increases of 0.20% (95% confidence interval, 0.02-0.39) and 0.14% (95% confidence interval, 0.05-0.24) in the PGT and FET rates, respectively. The live birth, ICSI rates and percentage of patients aged >40 years were not associated with increased industry payment rates to physicians.

Conclusion(s): Industry payments were not associated with differences in in vitro fertilization center outcomes overall. However, large centers with more physicians receiving industry payments may be more likely to use additional procedures such as PGT and FET, without improvement in the final outcomes such as the live birth rate. Further research is needed to determine whether these differences reflect the industry payment influence vs. individual center/provider practice habits in larger practices.