Newman, J. E., Paul, R. C., & Chambers, G. M. (2020). Assisted Reproductive Technology in Australia and New Zealand 2018. National Perinatal Epidemiology and Statistics Unit. https://doi.org/10.26190/unsworks/30474
Newman JE, Paul RC, Chambers GM. Assisted Reproductive Technology in Australia and New Zealand 2018. National Perinatal Epidemiology and Statistics Unit; 2020. doi:10.26190/unsworks/30474
Newman, Jade, et al. Assisted Reproductive Technology in Australia and New Zealand 2018. National Perinatal Epidemiology and Statistics Unit, 2020.
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RRM Academy Synopsis
ART Success Rates Decline Over Repeat Cycles, Registry Shows
This registry report tracked 15,404 women who started their first own-egg treatment cycle (ART, such as IVF) in Australia and New Zealand in 2016. About 2 out of 10 women had a baby on their first cycle, falling to about 1 out of 10 by the eighth. About 1 in 4 women stopped treatment after a cycle without a baby.
Key Findings
84,064 ART cycles were reported in Australia and New Zealand in 2018; 23.2% (19,514) resulted in a clinical pregnancy and 18.4% (15,475) in a live birth.
In a tracked cohort of 15,404 women who started their first own-egg fresh cycle in 2016, the live birth rate was 23.1% in cycle one and 11.6% in cycle eight.
Almost 1 in 4 women who did not have a live birth in a specific cycle did not return for another ART cycle before the end of 2018.
Live birth rates fell as women aged: for autologous fresh cycles reaching embryo transfer, women under 30 had a 40.4% live birth rate per transfer, versus 0.8% for women older than 44.
The multiple birth rate fell from 4.9% in 2014 to 3.2% in 2018, as single embryo transfer rose from 79.2% to 90.6% of embryo transfer cycles over the same period.
Interpretation
ANZARD is a national registry report. It describes what happened at every licensed clinic in Australia and New Zealand in 2018. The registry does not explain why. The cycle-by-cycle numbers cover a narrower group: women who started their first own-egg, non-frozen cycle in 2016, tracked through 2018. Women who used donor eggs, or who only had freeze-all cycles, are excluded. The report does not say why women without a baby left treatment. Reasons could include cost, migration, spontaneous pregnancy, or choice, none of which ANZARD collects. The drop in success by age and cycle number is a pattern. The pattern does not identify a cause for any one woman.
RRM Context
The registry counts what happens with ART, cycle by cycle. It does not ask why a woman's chance changed from cycle to cycle, or why many women stopped after a failed cycle. Restorative reproductive medicine asks a different question: what underlying condition is causing the infertility. A national registry can show that repeat cycles are common and success narrows with age. ANZARD was not built to find or treat a cause.
Our editorial summary of this paper, not the article's abstract.
Key figures
Treatment activity, 2018
Measure
Value
Source
Total ART treatment cycles reported, Australia and New Zealand, 2018
84,064
Summary
ART treatment cycles reported in Australia, 2018
76,341
Summary
ART treatment cycles reported in New Zealand, 2018
7,723
Summary
Share of ART treatments that were autologous cycles, 2018
94.1%
Summary
Share of autologous cycles using frozen and thawed embryos or oocytes, 2018
36.9%
Summary
Patient profile, 2018
Measure
Value
Source
Average age of women in autologous ART cycles, 2018, in years
35.8
Patient age section
Share of autologous cycle women aged 40 or older, 2018
23.7%
Patient age section
Pregnancy and birth outcomes, 2018
Measure
Value
Source
Clinical pregnancy rate per initiated ART cycle, 2018
23.2% (19,514)
Treatment outcomes section
Live birth rate per initiated ART cycle, 2018
18.4% (15,475)
Treatment outcomes section
Clinical pregnancy rate per embryo transfer, all ART cycles, 2018
34.4%
Treatment outcomes section
Live birth rate by cycle type, 2018
Measure
Value
Source
Live birth rate per initiated autologous fresh cycle, excluding freeze-all cycles, 2018
16.8%
Treatment outcomes section
Live birth rate per embryo transfer, autologous fresh cycles, 2018
24.5%
Treatment outcomes section
Live birth rate per initiated autologous thaw cycle, 2018
28.5%
Treatment outcomes section
Live birth rate per embryo transfer, autologous thaw cycles, 2018
29.4%
Treatment outcomes section
Live birth rate by age, 2018
Measure
Value
Source
Live birth rate per embryo transfer, autologous fresh cycles, women under 30, 2018
40.4%
Age-stratified outcomes section
Live birth rate per embryo transfer, autologous thaw cycles, women under 30, 2018
34.9%
Age-stratified outcomes section
Live birth rate per embryo transfer, autologous fresh cycles, women over 44, 2018
0.8%
Age-stratified outcomes section
Live birth rate per embryo transfer, autologous thaw cycles, women over 44, 2018
7.8%
Age-stratified outcomes section
Babies born and multiples, 2018
Measure
Value
Source
Total babies born following ART treatment, 2018
16,140
Babies born section
Liveborn babies following ART treatment, 2018
15,980
Babies born section
Share of ART babies that were full-term singletons of normal birthweight, 2018
81.5%
Babies born section
Five-year trend, 2014 to 2018
Measure
Value
Source
ART multiple birth rate, 2014 to 2018
4.9% to 3.2%
Multiple birth trends section
Single embryo transfer rate, 2014 to 2018
79.2% to 90.6%
Multiple birth trends section
Live birth rate per embryo transfer, 2014 to 2018
24.3% to 27.3%
Trends section
Rise in live birth rate per embryo transfer, 2014 to 2018
12.3%
Trends section
Our summary of the report's published figures, each citing its table, figure or section. The full report is at the publisher's link.
