PMID- 27207175 OWN - NLM STAT- MEDLINE DCOM- 20180205 LR - 20220410 IS - 1460-2350 (Electronic) IS - 0268-1161 (Linking) VI - 31 IP - 7 DP - 2016 Jul TI - International Committee for Monitoring Assisted Reproductive Technologies world report: Assisted Reproductive Technology 2008, 2009 and 2010. PG - 1588-609 LID - 10.1093/humrep/dew082 [doi] AB - STUDY QUESTION: What were utilization, outcomes and practices in assisted reproductive technology (ART) globally in 2008, 2009 and 2010? SUMMARY ANSWER: Global utilization and effectiveness remained relatively constant despite marked variations among countries, while the rate of single and frozen embryo transfers (FETs) increased with a concomitant slight reduction in multiple birth rates. WHAT IS KNOWN ALREADY: ART is widely practised in all regions of the world. Monitoring utilization, an approximation of availability and access, as well as effectiveness and safety is an important component of universal access to reproductive health. STUDY DESIGN, SIZE, DURATION: This is a retrospective, cross-sectional survey on utilization, effectiveness and safety of ART procedures performed globally from 2008 to 2010. PARTICIPANTS, SETTING, METHODS: Between 58 and 61 countries submitted data from a total of nearly 2500 ART clinics each year. Aggregate country data were processed and analyzed based on forms and methods developed by the International Committee for Monitoring Assisted Reproductive Technologies (ICMART). Results are presented at country, regional and global level. MAIN RESULTS AND THE ROLE OF CHANCE: For the years 2008, 2009 and 2010, >4 461 309 ART cycles were initiated, resulting in an estimated 1 144 858 babies born. The number of aspirations increased by 6.4% between 2008 and 2010, while FET cycles increased by 27.6%. Globally, ART utilization remained relatively constant at 436 cycles/million in 2008 and 474 cycles/million population in 2010, but with a wide country range of 8-4775 cycles/million population. ICSI remained constant at around 66% of non-donor aspiration cycles. The IVF/ICSI combined delivery rate (DR) per fresh aspiration was 19.8% in 2008; 19.7% in 2009 and 20.0% in 2010, with corresponding DRs for FET of 18.8, 19.7 and 20.7%. In fresh non-donor cycles, single embryo transfer increased from 25.7% in 2008 to 30.0% in 2010, while the average number of embryos transferred fell from 2.1 to 1.9, again with wide regional variation. The rates of twin deliveries following fresh non-donor transfers were, in 2008, 2009 and 2010, 21.8, 20.5 and 20.4%, respectively, with a corresponding triplet rate of 1.3, 1.0 and 1.1%. Fresh IVF and ICSI carried a perinatal mortality rate per 1000 births of 22.8 (2008), 19.2 (2009) and 21.0 (2010), compared with 15.1, 12.8 and 14.6/1000 births following FET in the same periods of observation. The proportion of women aged 40 years or older undergoing non-donor ART increased from 20.8 to 23.2% from 2008 to 2010. LIMITATIONS, REASON FOR CAUTION: The data presented are reliant on the quality and completeness of data submitted by individual countries. This report covers approximately two-thirds of the world ART activity. WIDER IMPLICATIONS OF FINDINGS: The ICMART World Reports provide the most comprehensive global statistical census and review of ART utilization, effectiveness, safety and quality. While ART treatment continues to increase globally, the wide disparities in access to treatment and embryo transfer practices warrant attention by clinicians and policy makers. STUDY FUNDING/COMPETING INTERESTS: The authors declare no conflict of interest and no specific support from any organizations in relation to this manuscript. ICMART acknowledges financial support from the following organizations: American Society for Reproductive Medicine; European Society for Human Reproduction and Embryology; Fertility Society of Australia; Japan Society for Reproductive Medicine; Japan Society of Fertilization and Implantation; Red Latinoamericana de Reproduccion Asistida; Society for Assisted Reproductive Technology; Government of Canada (Research grant), Ferring Pharmaceuticals (Grant unrelated to World Reports). TRIAL REGISTRATION: not applicable. CI - (c) The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com. FAU - Dyer, S AU - Dyer S AD - Department of Obstetrics & Gynaecology, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa silke.dyer@uct.ac.za. FAU - Chambers, G M AU - Chambers GM AD - National Perinatal Epidemiology and Statistics Unit, University of New South Wales, Sydney, Australia. FAU - de Mouzon, J AU - de Mouzon J AD - Institut National de la Sante et de la Recherche Medicale Service de Gynecologie Obstetrique II et de Medecine de la Reproduction, Groupe Hospitalier Cochin-Saint Vincet de Paul, Paris, France. FAU - Nygren, K G AU - Nygren KG AD - Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. FAU - Zegers-Hochschild, F AU - Zegers-Hochschild F AD - Clinica las Condes and Program of Ethics and Public Policies in Human Reproduction, University Diego Portales, Santiago, Chile. FAU - Mansour, R AU - Mansour R AD - Egyptian IVF-ET Center, Cairo, Egypt. FAU - Ishihara, O AU - Ishihara O AD - Department of Obstetrics and Gynaecology, Saitama Medical University, Moroyama, Japan. FAU - Banker, M AU - Banker M AD - Nova IVI Fertility, Chennai, India. FAU - Adamson, G D AU - Adamson GD AD - Palo Alto Medical Foundation Fertility Physicians of North California, San Jose, CA, USA. LA - eng PT - Journal Article DEP - 20160520 PL - England TA - Hum Reprod JT - Human reproduction (Oxford, England) JID - 8701199 SB - IM CIN - Hum Reprod. 2016 Jul;31(7):1381-2. PMID: 27207176 MH - Cross-Sectional Studies MH - Female MH - Health Services Accessibility MH - Humans MH - Pregnancy MH - Pregnancy Outcome MH - Reproductive Techniques, Assisted/adverse effects/statistics & numerical data/*trends MH - Research Report MH - Retrospective Studies OTO - NOTNLM OT - ICMART OT - IVF/ICSI outcome OT - assisted reproductive technology OT - frozen embryo transfer OT - multiple births OT - registry EDAT- 2016/05/22 06:00 MHDA- 2018/02/06 06:00 CRDT- 2016/05/22 06:00 PHST- 2016/03/10 00:00 [received] PHST- 2016/03/15 00:00 [accepted] PHST- 2016/05/22 06:00 [entrez] PHST- 2016/05/22 06:00 [pubmed] PHST- 2018/02/06 06:00 [medline] AID - dew082 [pii] AID - 10.1093/humrep/dew082 [doi] PST - ppublish SO - Hum Reprod. 2016 Jul;31(7):1588-609. doi: 10.1093/humrep/dew082. Epub 2016 May 20.