Assisted Reproduction · Registries and Reporting
RRM Academy Synopsis
Japan's 2016 ART Registry Recorded 54,110 Babies From 447,790 Cycles
This is a national registry report on 447,790 ART cycles carried out in Japan in 2016. The report draws on data from more than 600 ART facilities across Japan. The registry found that ART accounted for 1 in 18.1 babies born in Japan that year. The average patient age was 38.1.
Key Findings
- In 2016, 447,790 ART cycles were registered across 603 participating Japanese facilities, resulting in 54,110 neonates, about 1 in 18.1 babies born in Japan that year.
- Average patient age was 38.1 years for all registered cycles, compared with 35.6 years among cycles that ended in a live birth.
- Single embryo transfer was used in 81.0% of fresh cycles and 82.7% of frozen cycles, with singleton live birth rates of 96.4% in both groups.
- Of 251,399 egg retrieval cycles, 104,575 (41.6%) used a freeze-all approach with no fresh embryo transfer, and 187,132 frozen-thawed transfers were reported.
- The pregnancy rate per embryo transfer exceeded 40% for women up to age 33, fell below 30% after age 39, and dropped below 10% after age 44.
Interpretation
This is a descriptive report from Japan's national ART registry. The report summarizes results reported by more than 600 ART facilities in Japan in 2016. Clinics registered cycle data with JSOG for government subsidy purposes. Cycles were not randomly assigned to different treatments. The report can show patterns, such as age, embryo-transfer number, and freeze-all use. But it cannot prove that any one choice caused a result. The authors say it remains unclear if freezing all embryos helps women without polycystic ovary syndrome. Two 2018 trials found its ongoing pregnancy and live-birth rates were not different from fresh transfer. The findings describe practice in Japan only.
RRM Context
Restorative reproductive medicine looks for the specific cause of a couple's infertility. The approach treats that cause. RRM does not bypass it with a procedure. This registry does not look at causes. The registry only tracks who used ART and what happened next. The report shows a steep drop in success with age. Pregnancy rates were above 40% up to age 33. They fell below 10% after age 44. The drop in fertility with age is not unique to one treatment path.
Abstract
Purpose
The Japan Society of Obstetrics and Gynecology started an online cycle-based assisted reproductive technology (ART) registry system in 2007. This report presents the characteristics and treatment outcomes of ART registered for the cycles practiced during 2016.
Methods
Cycle-specific information for all ART cycles implemented in participating ART facilities were collected. A descriptive analysis was conducted for the registry database of 2016.
Results
In total, 447 790 treatment cycles and 54 110 neonates (one in 18.1 neonates born in Japan) were reported in 2016. The mean patients' age was 38.1 years (SD = 4.5). Among the egg retrieval cycles, 104 575 of 251 399 (41.6%) were freeze-all cycles without fresh embryo transfers (ET), while fresh ET was performed in 64 497 cycles (58.4%). A total of 187 132 frozen-thawed ET cycles were reported, resulting in 62 432 pregnancies and 44 484 neonates born. Single ET was selected for 81.0% of fresh transfers and 82.7% of frozen cycles, resulting in singleton pregnancy/live birth rates of 97.0%/96.4% and 96.7%/96.4%, respectively.
Conclusion
The total ART cycles and subsequent live births continued to increase in 2016. Single ET was performed more than 80%, and ET has shifted from using fresh embryos to frozen ones.
