Assisted Reproduction · Registries and Reporting
RRM Academy Synopsis
Japan's 2018 ART registry recorded 454,893 cycles and 56,979 neonates
Japan's national ART registry, in a descriptive report from 621 facilities, counted 454,893 cycles and 56,979 neonates in 2018. Frozen-thawed embryo transfers outnumbered the 50,463 fresh transfers. About 48 out of 100 oocyte retrievals were freeze-all cycles.
Key Findings
- In 2018 facilities registered 454,893 cycles and recorded 56,979 neonates, both increases over 2017; 621 facilities took part.
- Freeze-all cycles accounted for 118,378 (47.8%) of 247,402 oocyte retrievals, while fresh embryo transfer (ET) took place in 50,463 cycles, continuing a decline since 2015.
- Per embryo transfer, live birth rates were 24.1% for frozen-thawed cycles, which had a 34.7% pregnancy rate and a 25.5% miscarriage rate per pregnancy, and 14.7% for fresh cycles overall.
- Single ET accounted for 82.2% of fresh transfers. Fresh transfers reached singleton pregnancy and live birth rates of 97.2% each, and frozen-thawed transfers 97.0% and 97.2%.
- Up to age 35, pregnancy rates per ET exceeded 40%, falling below 10% after age 45; the miscarriage rate reached 32.1% at age 40 and 49.9% at age 43.
Interpretation
This descriptive analysis draws on cycle-level data from 621 of 622 facilities, and the authors consider selection bias from missing facilities unlikely. The report describes cycle characteristics and outcomes and includes no comparison with couples who received no treatment. The authors note that cycles from one patient are hard to link. They also state that freeze-all cycles, which account for nearly half of all initiated fresh cycles, affect rates per aspiration cycle markedly. Incomplete reporting of body mass index and parity prevents adjustment, and social oocyte freezing is outside the registry.
RRM Context
ART bypasses the reproductive system without resolving why conception has not occurred, and a cycle registry counts what happens after that bypass. Restorative reproductive medicine asks the earlier question: what is causing the infertility. It evaluates both partners, treats the cause, and uses cycle charting to follow the body's cycle.
Abstract
Purpose
Since 2007, the Japan Society of Obstetrics and Gynecology (JSOG) has collected cycle-based data for assisted reproductive technology (ART) in an online registry. Here, we present the characteristics and treatment outcomes of ART cycles registered during 2018.
Methods
The Japanese ART registry consists of cycle-specific information for all ART treatment cycles implemented at 621 participating facilities. We conducted descriptive analyses for such cycles registered for 2018.
Results
In total, 454 893 treatment cycles and 56 979 neonates were reported in 2018: both increased from 2017. The mean maternal age was 38.0 years (standard deviation ± 4.7). Of 247 402 oocyte retrievals, 118 378 (47.8%) involved freeze-all-embryos cycles; fresh embryo transfer (ET) was performed in 50 463 cycles: a decreasing trend since 2015. A total of 199 914 frozen-thawed ET cycles were reported, resulting in 69 357 pregnancies and 49 360 neonates born. Single ET (SET) was performed in 82.2% of fresh transfers and 83.4% of frozen-thawed cycles, with singleton pregnancy/live birth rates of 97.2%/97.2% and 97.0%/97.2%, respectively.
Conclusions
Total ART cycles and subsequent live births increased in 2018. SET was performed in over 80% of cases, and the mode of ET has shifted continuously from using fresh embryos to frozen-thawed ones compared with previous years.
