O-153 Assisted Reproductive Technology (ART) in Europe 2020 and development of a strategy of vigilance: Preliminary results generated from European registers by the ESHRE EIM Consortium
Authors: Smeenk J , Wyns C , De Geyter Ch , Bergh C , Cuevas I , de Neubourg D , Kupka M S , Rezabek K , Rugescu I , Tandler-Schneider A , Goossens V 
Published: June 2023

Abstract

Study question
What are the reported data on cycles in ART, IUI and fertility preservation interventions in 2020 as compared to previous years and what are the main trends over the years?

Summary answer: author
The 24rd ESHRE report on ART and IUI shows a progressive increase in reported treatment cycle numbers in Europe, a small decrease in the number of transfers (IVF + ICSI) with more than one embryo with a trend to decreasing multiple delivery rates, outcomes for IUI cycles are similar to previous years. WHAT IS KNOWN ALREADY: Since 1997, ART aggregated data generated by national registries, clinics or professional societies have been collected, analyzed by the European IVF-monitoring Consortium (EIM) and reported in 23 manuscripts published in Human Reproduction and Human Reproduction Open.

Study design, size, duration
Yearly collection of European medically assisted reproduction (MAR) data by EIM for ESHRE. The data on treatments performed between January 1 and December 31 2020 in 35 European countries were provided by either National Registries or registries based on personal initiatives of medical associations and scientific organizations.

Participants/materials, setting, methods
In all, 1157 clinics offering ART services in 35 countries reported a total of 713 708 treatment cycles, involving 110 097 with IVF, 253 095 with ICSI, 239 759 with frozen embryo replacement (FET), 46 610 with preimplantation genetic testing (PGT), 59 906 with egg donation (ED), 344 with IVM of oocytes and 3897 cycles with frozen oocyte replacement (FOR). European data on IUI using husband/partner’s semen (IUI-H) and donor semen (IUI-D) were reported from 1176 institutions offering IUI in 28 and 18 countries, respectively. A total of 102 702 treatments with IUI-H and 36 476 treatments with IUI-D were included. A total of 18 270 fertility preservation (FP) interventions from 15 countries including oocyte, ovarian tissue, semen and testicular tissue banking in pre-and post-pubertal patients were reported.

Main results and the role of chance
In total, 1157 IVF clinics participated (88.5% of registered clinics in the participating countries). Next to these also 1176 IUI units reported their data. In the 35 reporting countries, after IVF the clinical pregnancy rates (PR) per aspiration and per transfer in 2020 were similar to those observed in 2019 (27.9% and 32.9% versus 28.5% and 34.6%, respectively). After ICSI the corresponding rates were also similar to those achieved in 2019 (24.3% en 32.2% versus 26.2% and 33.5%). After FET with own embryos, the PR per thawing is stabilizing, 35.1% in 2019 and 34.6% in 2020. After ED the PR per fresh embryo transfer was 50.4% (50.5% in 2019) and per FOR 45.3% (44.8% in 2019). In IVF and ICSI together, the trend towards the transfer of fewer embryos continues with the transfer of 1, 2, 3 and ≥4 embryos in 62.1%, 32.3%, 2.2% and 0.3% of all treatments, respectively (corresponding to 55.4%, 39.9%, 2.6% and 0.2% in 2019). This resulted in a proportion of singleton, twin and triplet DRs of 90.5%, 9.3% and 0.2%, respectively (compared to 87.7%, 12.0% and 0.3%, respectively in 2019). Treatments with FER in 2020 resulted in twin and triplet DR of 7.0% and 0.1%, respectively (versus 9.3% and 0.1% in 2019). After IUI, the DRs remained similar at 8.9% after IUI-H (9.2% in 2019) and at 12.4% after IUI-D (12.1% in 2019). Twin and triplet DRs after IUI-H were 8.3% and 0.4%, respectively (in 2019: 8.7% and 0.3%) and 5.8% and 0.2% after IUI-D (in 2019: 6.2% and 0.2%). The majority of FP interventions included the cryopreservation of oocytes (n = 5 365 from 14 countries) and of ejaculated sperm (n = 11 571 from 14 countries).

Limitations, reasons for caution
As the methods of data collection and levels of completeness of reported data vary among European countries, the results should be interpreted with caution. For this abstract, some countries were not able to provide adequate data about the number of centers and initiated cycles and deliveries. WIDER IMPLICATIONS OF THE FINDINGS: The 24rd ESHRE report on ART and IUI shows a continuous increase of reported treatment numbers and MAR-derived live births in Europe. Being already the largest data collection on MAR in Europe, continuous efforts to stimulate data collection and reporting strive for future quality control and completeness of the data and offer higher transparency and vigilance in the field of reproductive medicine.

Trial registration number
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