Use of medically assisted reproduction in Europe increased from 2020 to 2021

Key takeaways:

• Use of medically assisted reproduction increased by 20% from 2020 to 2021.
• Use of one embryo per transfer for IVF and intracytoplasmic sperm injection treatments combined rose from 2020 to 2021.

In Europe, use of medically assisted reproduction increased in 2021 compared with 2020, according to preliminary data presented at the European Society of Human Reproduction and Embryology annual meeting.

“The key take-home messages are the following three points,” Jesper Smeenk, MD, PhD, from the department of gynecology and obstetrics at the Elisabeth-TweeSteden Hospital in Tilburg, Netherlands, told Healio. “Full recovery of number of cycles after COVID-19 were at an all-time high, there were stable results in terms of cumulative pregnancy rates and the number of single-embryo transfers, and as a result, number of multiples were at an all-time low.”

Smeenk and colleagues evaluated national registry, medical association and scientific organization data on 910,470 medically assisted reproduction treatment cycles by the European IVF-monitoring Consortium from January to December 2021 in 1,155 clinics offering assisted reproductive technology (ART) services in 34 European countries. Researchers also evaluated European data from 1,242 institutions on intrauterine insemination using partner’s semen in 29 countries (n = 139,350) and donor semen in 21 countries (n = 45,532). Researchers also assessed 28,692 fertility preservation interventions, including oocyte, ovarian tissue, semen and testicular tissue banking, from 15 European countries.

Overall, 1,103,633 ART treatment cycles were reported in 2021, which was a 20% increase from the 919,364 cycles reported in 2020. In terms of ART type, 115,567 cycles were IVF, 346,183 were intracytoplasmic sperm injections, 311,487 were frozen embryo replacements, 62,694 were preimplantation genetic testing cycles, 69,883 were egg donations, 246 were in vitro maturation of oocytes and 4,410 were frozen oocyte replacements.

In 2021, clinical pregnancy rates after IVF, intracytoplasmic sperm injection and frozen embryo transfer were similar to those observed in 2020. However, after egg donation, the clinical pregnancy rate per fresh embryo transfer rose from 51.3% in 2020 to 53.1% in 2021, and clinical pregnancy rate per frozen oocyte replacement rose from 43.9% in 2020 to 45.5% in 2021.

The use of one embryo per transfer for IVF and intracytoplasmic sperm injection combined rose from 57.9% in 2020 to 60.5% in 2021. Conversely, the use of four or more embryos per transfer were 0.2% in both 2020 and 2021. Due to this, the proportion of singleton births rose from 88.9% in 2020 to 90.4% in 2021, and the proportion of twins and triplets fell from 10.9% and 0.2% in 2020, respectively, to 9.5% and 0.1% in 2021, respectively.

With intrauterine insemination, clinical pregnancy rates with use of partner’s semen or donor semen were similar in 2020 and 2021.

According to Smeenk, moving forward, cycle-by-cycle evaluation is needed that takes confounders into account.

“There are now less complications due to single-embryo transfer and more frozen embryo transfers,” Smeenk said. “There is strong evidence to proceed with a single-embryo transfer policy.”