P-460 The Impact of Assisted Reproductive Technologies on Climate Change : The French Case
Authors: Saïs E , Bendayan M , Sellami I , Alter L , Fathallah K , Swierkowski-Blanchard N , Sonigo C , Boitrelle F , Grynberg M 
Published: June 2023

Abstract

Study question
How much tons of carbon dioxide equivalent (tCO2e) are generated by Assisted Reproductive Technologies in France in a year ?

Summary answer
It is estimated that Assisted Reproductive Technologies generated 55 691 tons of carbon dioxide equivalent in France in 2022.

What is known already
Since the 1800s, human activities have been the main driver of climate change, primarily due to burning fossil fuels (coal, oil and gas). Created in 1988, the Intergovernmental Panel on Climate Change (IPCC) provides regular assessments of the scientific basis of climate change, its impacts and future risks, and options for adaptation and mitigation. On December 12th 2015, 196 Parties adopted The Paris Agreement at COP 21 (Paris), a legally binding international treaty on climate change, aiming to limit global warming to well below 2 degrees Celsius. The French health sector is only beginning to measure it's carbon emission footprint.

Study design, size, duration
This study was conducted in Poissy/Saint-Germain-En-Laye Hospital during the year 2022 in the Department of reproductive medicine and biology. Greenhouse gas emissions were classified into three scopes. Scope 1 emissions are direct emissions divided into four categories : stationary combustion, mobile combustion, fugitive emissions, process emissions. Scope 2 emissions are indirect emissions from the generation of purchased energy. Scope 3 emissions are all indirect emissions, including both upstream and downstream emissions (separated into 15 categories).

Participants/materials, setting, methods
Every couple that required IVF or ICSI (including donors) during the year 2022 was included in this study. Number of personnel, transportation of patients, total medication prescribed, electricity consumption and medical furnitures were considered for the calculus of total emissions. Emission factors to calculate carbon emission were taken on the Ecological Transition Agency (ADEME) database. Extrapolation to all of France's ART clinics was possible using the BioMedical Agency (ABM) 2020 report on ART activities.

Main results and the role of chance
Assisted Reproductive Technologies generated 55 691 tons of carbon dioxide equivalent (tCO2e) in France in 2022 from 30 963 ICSI and 15 674 IVF procedures.
We estimate that every oocyte retrieval procedure generated 1.19 tCO2e (ICSI and IVF).
Department of Reproductive Medicine and Biology of Poissy/Saint-Germain-En-Laye (PSGEL) generated 796 tCO2e from 666 oocyte retrieval procedures (449 ICSI, 217 IVF), representing 1.43% of all IVF and ICSI in France.
Electricity consumption at PGSEL generated 1 051 tCO2e based on a total of 14 200 kw/h (average price of 0.1740 euros) in 2022.
Drugs prescriptions (758 069 euros) and Furniture (194 648 euros) at PGSEL generated respectively 409.584 tCO2e and 61.314 tCO2e in 2022 .
32 members of medical and non-medical at PGSEL staff generated 320 tCO2e in 2022.
Transportation of patients to PGSEL generated 4.44 tCO2e in 2022.
This is the first study to report an estimation of the carbon emission footprint of French ART.

Limitations, reasons for caution
Not all data was available (CO2 emissions created by the manufacture of active pharmaceutical ingredients in Asia) or taken into account (waste management, anesthesia type, hospital construction, etc).
Fertility preservation procedures were not considered in our calculations.
Results are therefore an under-estimation of real CO2 emissions.

Wider implications of the findings
French Healthcare was responsible for 46 MtCO2e (8% of national total) in 2021.
The biggest impact we can have in ART to lower our carbon footprint is optimise the pharmaceutical supply chain of drug manufacturing and use recycled materials for drug packaging (plastic, glass, aluminium, steel) as much as possible.

Trial registration number
not applicable