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Report indicates general increase in assisted reproductive technology during 2002
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According to the eighth World Collaborative Report on Assisted Reproductive Technology, assisted reproductive technology activity increased during 2002 compared with the last report in 2000. In addition, both pregnancy and delivery rates increased during this time, despite a decrease in the number of embryos transferred.
"Assisted reproductive technology has become almost a routine treatment in many countries (approximately 250,000 babies per year in the world) but is still in the field of medical research," Jacques Mouzon, MD, of the French National Institute for Health and Medical Research in Paris, told Endocrine Today. "Assisted reproductive technology practice is increasing, and performance and safety are improving."
Researchers gathered data from national registries in Australia and New Zealand, Europe and North America and from individual ART units in Latin America and the Middle East. Data were sent from national registries in Asia and Israel to The International Committee for Monitoring Assisted Reproductive Technology. In total, the report included data from 1,563 clinics in 53 countries.
More than 601,243 initiated cycles yielded a 22.4% delivery rate per aspiration for conventional in vitro fertilization, 21.2% for intracytoplasmic sperm injection, and 15.3% for frozen embryo transfer. The largest number of aspirations were reported by the United States, followed by Germany and France. However, Europe had the largest contribution on a regional basis (56.4%).
Frozen embryo transfer represented 21.7% of the aspiration number in 2002 compared with 14.4% in 2000. During 2002, this proportion varied from >64% in Finland, Australia and Switzerland to <10% in 23 countries. The percentage of transfers with four or more embryos decreased from 15.4% in 2000 to 13.7% in 2002; single embryo transfers increased from 10.5% to 12.4%.
Among the fertilization procedures, 56.6% were Intracytoplasmic Sperm Injection in 2002 vs. 47.6% in 2000. In 2002, this procedure reached 75.9% in Latin America and 92.4% in the Middle East.
"This report may reassure professionals in that decreasing the number of transferred embryos results in a decrease in the multiple pregnancy rates, thus improving newborn health status without decreasing the pregnancy rate," Mouzon said.
The overall proportion of twin pregnancies decreased from 26.5% in 2000 to 25.7% in 2002, and triplet pregnancies decreased from 2.9% in 2000 to 2.5% in 2002.
“It is encouraging to note a decrease in the mean number of transferred embryos and multiple birth rate in almost all countries,” the researchers wrote. “However, as one triplet pregnancy results in three triplet babies, this means that 14.6% of ART babies were triplet in Latin America, 10.9% in the Middle East, 8.2% in the United States, 3.1% in Europe and 2.0% in Australia and New Zealand.” – by Jennifer Southall
de Mouzon J. Hum Reprod. 2009;doi:10.1093/humrep/dep098.