According to the 2002 World report on ART presented at the 22nd annual conference of the European Society of Human Reproduction and Embryology, 200,000 ART babies were born around the world in 2002. This compares with about 30,000 born in 1989, which was the first year that data were collected for the World report.
The report includes data from 52 countries, covering almost 600,000 ART cycles and 122,000 newborn babies. Dr Jacques de Mouzon, a member of the International Committee for Monitoring Assisted Reproductive Technologies (ICMART), told the conference: "The ICMART report covers two-thirds of the world's ART activity, so the total number of ART cycles in the world can be estimated at one million a year, and the number of ART babies produced at around 200,000 a year."
Since the previous World report for the year 2000, another four countries have started to contribute data to ICMART and there has been an increase of 100,000 cycles and 20,000 newborn babies. Data from most of Africa and many Asian countries is still missing.
One in six couples worldwide experience some form of infertility problem, but there are huge variations in availability and efficacy of ART between countries.
Dr de Mouzon said: "The average pregnancy rate for each cycle using fresh embryos was 25.1% and the delivery rate was 18.5%. However, these rates varied from 13.6% to 40.5% for pregnancy, and 9.1% to 37.1% for delivery. Availability was highest in Israel where there were 3,260 cycles per million inhabitants, followed by Denmark with 2,031 cycles per million, and it was lowest in most of the Latin American countries where there were less than 100 cycles per million."
Europe leads the world for ART treatment, initiating nearly 56% of all reported ART cycles. Almost 50% of the reported cycles in the world were in just four countries: USA (112,000), Germany (85,000), France (64,000) and the UK (37,000).
Another important phenomenon revealed by the world data is the trend away from multiple embryo transfers (and multiple pregnancies) towards single embryo transfer (SET).
"If we compare 2002 with 1998, there is a decline in several countries in the number of transferred embryos. However, this has not resulted in a sharp drop in the pregnancy rate except in the USA, indicating that efficacy is improving. The average number of embryos transferred in Europe now is 2.2%, while in the States it has dropped from 3.5% to 2.9%."
The percentage of ART births out of all births was highest in Denmark at 3.9% and lowest in Latin America at less than 0.1%.
"There is a real inequality between the different countries, and this is due to money," said Dr de Mouzon. "Some countries provide free cycles of IVF, while in others, couples cannot have ART unless they can pay for it, for example through medical insurance."
Professor Anders Nyboe Andersen presented figures from 2003 in Europe to the conference. The report from the ESHRE European IVF Monitoring committee included data from 28 European countries. There were 357,884 cycles in 2003, which represents a 10% increase on the previous year.
He said: "The trend towards single embryo transfer is the most important message. The Nordic countries and Belgium lead the way in this. In Sweden today there is 70% elective SET, which has resulted in a decline in twin birth rates to 5%, which is sensational. Triplets have virtually disappeared in Europe, but there are still countries where the triplet rate is too high.
"Elective SET is only of major importance in Finland, Sweden and Belgium. They have achieved this in different ways. In Finland, it has happened because patients and clinicians have chosen to do it. In Sweden, it has been achieved through regulation, and in Belgium it has been achieved through financial incentives, whereby patients have their IVF treatment paid for them by the state if they choose SET."
Professor Karl Nygren, chairman of the ESHRE EIM and ICMART committees, said: "These two reports together document the fact that the technique of IVF is spreading rapidly around the world, not only in Europe, but everywhere, although there are still inequalities in availability and efficacy between countries. ART is being used increasingly in India and China and we look forward to them contributing data in the future."
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