Osamu Ishihara1, G David Adamson2, Silke Dyer3, Jacques de Mouzon4, Karl G Nygren5, Elizabeth A Sullivan6, Fernando Zegers-Hochschild7, Ragaa Mansour8. 1. Department of Obstetrics and Gynaecology, Saitama Medical University, Moroyama, Japan. Electronic address: osamishr@saitama-med.ac.jp. 2. Palo Alto Medical Foundation Fertility Physicians of North California, San Jose, California. 3. Department of Obstetrics & Gynaecology, Groote Schuur Hopsital and Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. 4. National Institute for Health and Medical Research, Gynecology, Obstetrics and Reproductive Medicine Unit, Cochin-Saint Vincent de Paul University Hospital, Paris, France. 5. Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden. 6. Faculty of Health, University of Technology, Sydney, Sydney, New South Wales, Australia. 7. Clinica las Condes and Program of Ethics and Public Policies in Human Reproduction, University Diego Portales, Santiago, Chile. 8. Egyptian In Vitro Fertilization-Embryo Transfer Center, Cairo, Egypt.
Abstract
OBJECTIVE: To analyze information on assisted reproductive technology (ART) performed worldwide, and trends in outcomes over successive years. DESIGN: Cross-sectional survey on access, efficiency, and safety of ART procedures performed in 55 countries during 2007. SETTING: Not applicable. PATIENT(S): Infertile women and men undergoing ART globally. INTERVENTION(S): Collection and analysis of international ART data. MAIN OUTCOME MEASURE(S): Number of cycles performed, by country and region, including pregnancies, single and multiple birth rates, and perinatal mortality. RESULT(S): Overall, >1,251,881 procedures with ART were reported, and resulted in 229,442 reported babies born. The availability of ART varied by country, from 12 to 4,140 treatments per million population. Of all aspiration cycles, 65.2% (400,617 of 614,540) were intracytoplasmic sperm injection. The overall delivery rate per fresh aspiration was 20.3%, and for frozen-embryo transfer (FET), 18.4%, with a cumulative delivery rate of 25.8%. With wide regional variations, single-embryo transfer represented 23.4% of fresh transfers, and the proportion of deliveries with twins and triplets from fresh transfers was 22.3% and 1.2%, respectively. The perinatal mortality rate was 19.9 per 1,000 births for fresh in vitro fertilization using intracytoplasmic sperm injection, and 9.6 per 1,000 for FET. The proportion of women aged ≥40 years increased to 19.8% from 15.5% in 2006. CONCLUSION(S): The international trend toward <3 transferred embryos continued, as did the wider uptake of FET. This was achieved without compromising delivery rates. The application of ART for women aged >40 years was a major component of ART services in some regions and countries.
OBJECTIVE: To analyze information on assisted reproductive technology (ART) performed worldwide, and trends in outcomes over successive years. DESIGN: Cross-sectional survey on access, efficiency, and safety of ART procedures performed in 55 countries during 2007. SETTING: Not applicable. PATIENT(S): Infertile women and men undergoing ART globally. INTERVENTION(S): Collection and analysis of international ART data. MAIN OUTCOME MEASURE(S): Number of cycles performed, by country and region, including pregnancies, single and multiple birth rates, and perinatal mortality. RESULT(S): Overall, >1,251,881 procedures with ART were reported, and resulted in 229,442 reported babies born. The availability of ART varied by country, from 12 to 4,140 treatments per million population. Of all aspiration cycles, 65.2% (400,617 of 614,540) were intracytoplasmic sperm injection. The overall delivery rate per fresh aspiration was 20.3%, and for frozen-embryo transfer (FET), 18.4%, with a cumulative delivery rate of 25.8%. With wide regional variations, single-embryo transfer represented 23.4% of fresh transfers, and the proportion of deliveries with twins and triplets from fresh transfers was 22.3% and 1.2%, respectively. The perinatal mortality rate was 19.9 per 1,000 births for fresh in vitro fertilization using intracytoplasmic sperm injection, and 9.6 per 1,000 for FET. The proportion of women aged ≥40 years increased to 19.8% from 15.5% in 2006. CONCLUSION(S): The international trend toward <3 transferred embryos continued, as did the wider uptake of FET. This was achieved without compromising delivery rates. The application of ART for women aged >40 years was a major component of ART services in some regions and countries.
Authors: A Taugourdeau; V Desquiret-Dumas; J F Hamel; S Chupin; L Boucret; V Ferré-L'Hotellier; P E Bouet; P Descamps; V Procaccio; P Reynier; P May-Panloup Journal: J Assist Reprod Genet Date: 2018-10-25 Impact factor: 3.412