11 papers

Christine Wyns

Registries and Reporting · National Registry Data

ART in Europe, 2020: results generated from European registries by ESHRE

De Geyter C et al., 2025 Human Reproduction

**STUDY ** What are the data and trends of ART and IUI cycle numbers and their outcomes, and of fertility preservation (FP) interventions, reported in 2020 as compared to previous years? **SUMMARY ** This 24th ESHRE report highlights the number of ART treatment cycles and children born over the years, showing a decline in the total number of treatment cycles, when comparing 2020 with 2019, alongside a decline in twin deliveries owing to a decrease in transfers of multiple embryos; however, fresh IVF or ICSI cycles and frozen embryo transfers (FET) showed similar pregnancy rates, and the reported IUI cycle numbers decreased while maintaining stable outcomes. **WHAT ** ART aggregated data generated by national registries, clinics, or professional societies have been gathered and analyzed by the European IVF Monitoring (EIM) consortium since 1997 and reported in a total of 23 manuscripts published in *Human Reproduction* and *Human Reproduction Open*. **STUDY DESIGN, SIZE, ** Data on medically assisted reproduction (MAR) from European countries are collected by EIM for ESHRE each year. The data on treatment cycles performed between January 1 and December 31, 2020, were provided by either national registries or registries based on initiatives of medical associations and scientific organizations or committed persons in the 44 countries that are members of the EIM Consortium. **PARTICIPANTS/MATERIALS, SETTING, ** Overall, 1440 clinics offering ART services in 41 countries reported 923 318 treatment cycles (−14%; in 2019: 1 077 813), including 135 231 with IVF, 356 408 with ICSI, 305 373 with FET, 57 051 with preimplantation genetic testing (PGT), 64 007 with oocyte donation, and 4895 cycles using frozen oocytes. A total of 1288 institutions reported data on IUI cycles using either husband/partner's semen (IUI-H; n = 112 663) or donor semen (IUI-D; n = 38 839) in 30 and 21 countries, respectively. Sixteen countries reported 29 566 interventions in pre-and post-pubertal patients for FP, including oocyte, ovarian tissue, semen, and testicular tissue banking. **MAIN ** In 24 countries (21 in 2019) in which all ART clinics reported to the registry, 356 427 treatment cycles were registered for a total population of approximately 268 million inhabitants in these countries, allowing the best estimate of a mean of 1330 cycles performed per million inhabitants (range: 142–3230). Among the reporting countries, for IVF, the clinical pregnancy rates (PR) per aspiration were similar to that in 2019 (22.1% versus 21.8% in 2019). For ICSI, the corresponding PRs showed similar trends (20.0% in 2020 versus 20.2% in 2019). When freeze-all cycles were excluded from the calculations, the clinical PRs per aspiration were 26.4% (28.5% in 2019) and 25.6% (26.2% in 2019) for IVF and ICSI, respectively. After oocyte donation, the PR per embryo transfer was 51.3% (50.5% in 2019) with freshly donated oocytes and 45.7% (44.8% in 2019) with thawed oocytes. After FET, the PR per thawing was 34.9% (versus 35.1% in 2019). In fresh cycles of both IVF and ICSI, the trend towards the transfer of fewer embryos continued with the transfer of 1, 2, 3, and ≥4 embryos in 57.2%, 37.8%, 4.8%, and 0.2%, of all treatments, respectively (corresponding to 55.4%, 39.9%, 2.6%, and 0.2% in 2019). This resulted in a reduced proportion of twin delivery rates (DRs) of 10.9% (11.9% in 2019) and a similar triplet DR of 0.2%. In FET cycles in 2020, the twin and triplet DRs were 7.9% and 0.1%, respectively (versus 8.9% and 0.1% in 2019). While the number of IUI cycles in 2020 decreased from 2019, the DRs remained stable at 8.8% after IUI-H (8.7% in 2019) and at 12.5% after IUI-D (12.1% in 2019). Twin and triplet DRs after IUI-H were 7.9% and 0.4% (in 2019: 8.7% and 0.4%) and 5.7% and 0.1% after IUI-D (in 2019: 6.2% and 0.2%), respectively. Data on FP were provided by 16 countries (18 in 2019), reporting a total of 29 566 interventions (24 139 in 2019). Cryopreservation of ejaculated sperm (n = 21 864 versus n = 11 592 in 2019) and cryopreservation of oocytes (n = 6077 versus n = 10 784 in 2019) were the most frequently reported forms of FP. **LIMITATIONS, ** Caution with the interpretation of results should remain as data collection systems and completeness of reporting vary among European countries.

Registries and Reporting · National Registry Data

O-159 Assisted Reproductive Technology (ART) in Europe 2022: preliminary results generated from European registers by the ESHRE EIM consortium

de Neubourg D et al., 2025 Human Reproduction

Abstract What are the reported data on cycles in ART, IUI and fertility preservation interventions in 2022 as compared to previous years and what are the main trends over the years? author The 26th ESHRE report on ART and IUI shows a status quo in reported treatment cycle numbers in Europe and a small decrease in the number of transfers (IVF + ICSI) with more than one embryo with a trend to decreasing multiple delivery rates, outcomes for IUI cycles are similar to previous years. Since 1997, ART aggregated data generated by national registries, clinics or professional societies have been collected, analyzed by the European IVF-monitoring Consortium (EIM) and reported in 23 manuscripts published in Human Reproduction and Human Reproduction Open. Study design, size, duration Yearly collection of European medically assisted reproduction (MAR) data by EIM for ESHRE. The data on treatments performed between January 1 and December 31, 2022, in 39 European countries were provided by either National Registries or registries based on personal initiatives of medical associations and scientific organizations. Participants/materials, setting, In all 1315 clinics offering ART services in 39 countries reported a total of 934 144 treatment cycles, involving 135 340 with IVF, 295 869 with ICSI, 364 202 with frozen embryo replacement (FET), 91 705 with preimplantation genetic testing (PGT), 40 976 with egg donation (ED), 473 with IVM of oocytes and 5579 cycles with frozen oocyte replacement (FOR). European data on IUI using husband/partner’s semen (IUI-H) and donor semen (IUI-D) were reported from 1234 institutions offering IUI in 31 and 22 countries, respectively. A total of 125 434 treatments with IUI-H and 42 156 treatments with IUI-D were included. A total of 30 700 fertility preservation (FP) interventions from 14 countries including oocyte, ovarian tissue, semen and testicular tissue banking in pre-and post-pubertal patients were reported. Main In total, 1315 IVF clinics participated (78.3% of registered clinics in the participating countries). Next to these also 1234 IUI units reported their data. In the 39 reporting countries, after IVF the clinical pregnancy rates (PR) per aspiration and per transfer in 2022 were similar to those observed in 2021 (24.2% and 45.7% versus 26.3% and 43.3%, respectively). After ICSI the corresponding rates were also similar to those achieved in 2021 (23.3% en 45.4% versus 24.0% and 47.4%). After FET with own embryos, the PR per thawing has dropped slightly to 31.8% in 2022 (36.2% in 2021). After ED the PR per fresh embryo transfer stabilized in comparison to 2021 (50.8% in 2022 vs 53.0% in 2021) and decreased a little for FOR 40.0% (45.5% in 2021). In IVF and ICSI together, the trend towards the transfer of fewer embryos continues with the transfer of 1, 2, 3 and ≥4 embryos in 66.8%, 31.6%, 1.4% and 0.1% of all treatments, respectively (corresponding to 61.0%, 34.4%, 1.8% and 0.2% in 2021). This resulted in a proportion of singleton, twin and triplet DRs of 92.2%, 7.7% and 0.1%, respectively (compared to 90.5%, 9.4% and 0.1%, respectively in 2021). Treatments with FER in 2021 resulted in twin and triplet DR of 5.5% and 0.1%, respectively (versus 6.8% and 0.1% in 2021). After IUI, the DRs remained similar at 8.6% after IUI-H (9.0% in 202) and at 13.3% after IUI-D (13.9% in 2021). Twin and triplet DRs after IUI-H were 7.3% and 0.2%, respectively (in 2021: 7.2% and 0.2%) and 6.0% and 0.1% after IUI-D (in 2021: 5.9% and 0.2%). The majority of FP interventions included the cryopreservation of oocytes (n = 14 659 from 14 countries) and of ejaculated sperm (n = 14 588 from 13 countries). Limitations, As the methods of data collection and levels of completeness of reported data vary among European countries, the results should be interpreted with caution. For this abstract, some countries were not able to provide adequate data about the number of centers and initiated cycles and deliveries. The 26th ESHRE report on ART and IUI shows a continuous increase of reported treatment numbers and MAR-derived live births in Europe. Being already the largest data collection on MAR in Europe, continuous efforts to stimulate data collection and reporting strive for future quality control and completeness of the data and offer higher transparenc

Registries and Reporting · National Registry Data

ART in Europe, 2019: results generated from European registries by ESHRE

Smeenk J et al., 2023 Human Reproduction

**STUDY ** What are the data and trends on ART and IUI cycle numbers and their outcomes, and on fertility preservation (FP) interventions, reported in 2019 as compared to previous years? **SUMMARY ** The 23rd ESHRE report highlights the rising ART treatment cycles and children born, alongside a decline in twin deliveries owing to decreasing multiple embryo transfers; fresh IVF or ICSI cycles exhibited higher delivery rates, whereas frozen embryo transfers (FET) showed higher pregnancy rates (PRs), and reported IUI cycles decreased while maintaining stable outcomes. **WHAT ** ART aggregated data generated by national registries, clinics, or professional societies have been gathered and analyzed by the European IVF-Monitoring (EIM) Consortium since 1997 and reported in a total of 22 manuscripts published in *Human Reproduction* and *Human Reproduction Open*. **STUDY DESIGN, SIZE, ** Data on medically assisted reproduction (MAR) from European countries are collected by EIM for ESHRE each year. The data on treatment cycles performed between 1 January and 31 December 2019 were provided by either national registries or registries based on initiatives of medical associations and scientific organizations or committed persons in one of the 44 countries that are members of the EIM Consortium. **PARTICIPANTS/MATERIALS, SETTING, ** Overall, 1487 clinics offering ART services in 40 countries reported, for the second time, a total of more than 1 million (1 077 813) treatment cycles, including 160 782 with IVF, 427 980 with ICSI, 335 744 with FET, 64 089 with preimplantation genetic testing (PGT), 82 373 with egg donation (ED), 546 with IVM of oocytes, and 6299 cycles with frozen oocyte replacement (FOR). A total of 1169 institutions reported data on IUI cycles using either husband/partner's semen (IUI-H; n = 147 711) or donor semen (IUI-D; n = 51 651) in 33 and 24 countries, respectively. Eighteen countries reported 24 139 interventions in pre- and post-pubertal patients for FP, including oocyte, ovarian tissue, semen, and testicular tissue banking. **MAIN ** In 21 countries (21 in 2018) in which all ART clinics reported to the registry 476 760 treatment cycles were registered for a total population of approximately 300 million inhabitants, allowing the best estimate of a mean of 1581 cycles performed per million inhabitants (range: 437–3621). Among the reporting countries, for IVF the clinical PRs per aspiration slightly decreased while they remained similar per transfer compared to 2018 (21.8% and 34.6% versus 25.5% and 34.1%, respectively). In ICSI, the corresponding PRs showed similar trends compared to 2018 (20.2% and 33.5%, versus 22.5% and 32.1%) When freeze-all cycles were not considered for the calculations, the clinical PRs per aspiration were 28.5% (28.8% in 2018) and 26.2% (27.3% in 2018) for IVF and ICSI, respectively. After FET with embryos originating from own eggs, the PR per thawing was at 35.1% (versus 33.4% in 2018), and with embryos originating from donated eggs at 43.0% (41.8% in 2018). After ED, the PR per fresh embryo transfer was 50.5% (49.6% in 2018) and per FOR 44.8% (44.9% in 2018). In IVF and ICSI together, the trend toward the transfer of fewer embryos continues with the transfer of 1, 2, 3, and ≥4 embryos in 55.4%, 39.9%, 2.6%, and 0.2% of all treatments, respectively (corresponding to 50.7%, 45.1%, 3.9%, and 0.3% in 2018). This resulted in a reduced proportion of twin delivery rates (DRs) of 11.9% (12.4% in 2018) and a similar triplet DR of 0.3%. Treatments with FET in 2019 resulted in twin and triplet DR of 8.9% and 0.1%, respectively (versus 9.4% and 0.1% in 2018). After IUI, the DRs remained similar at 8.7% after IUI-H (8.8% in 2018) and at 12.1% after IUI-D (12.6% in 2018). Twin and triplet DRs after IUI-H were 8.7% and 0.4% (in 2018: 8.4% and 0.3%) and 6.2% and 0.2% after IUI-D (in 2018: 6.4% and 0.2%), respectively. Eighteen countries (16 in 2018) provided data on FP in a total number of 24 139 interventions (20 994 in 2018). Cryopreservation of ejaculated sperm (n = 11 592 versus n = 10 503 in 2018) and cryopreservation of oocytes (n = 10 784 versus n = 9123 in 2018) were most frequently reported. **LIMITATIONS, ** Caution with the interpretation of results should remain as data collection systems and completeness of reporting vary among European countries.

Registries and Reporting · National Registry Data

ART in Europe, 2018: results generated from European registries by ESHRE

Wyns C et al., 2022 Human Reproduction Open

--- title: "ART in Europe, 2018: results generated from European registries by ESHRE" source_file: "eshre-eim-2018-source.pdf" journal: "Human Reproduction Open" volume_pages: "pp. 1–20, 2022" doi: "https://doi.org/10.1093/hropen/hoac022" authors: "Wyns C, De Geyter C, Calhaz-Jorge C, Kupka MS, Motrenko T, Smeenk J, Bergh C, Tandler-Schneider A, Rugescu IA, Goossens V" pages: 20 extracted_date: "2026-04-24" figures_extracted: 9 tables_extracted: 5 review_flags: 0 --- --- title: "ART in Europe, 2018: results generated from European registries by ESHRE" journal: "Human Reproduction Open" pages: "1–20, 2022" doi: "https://doi.org/10.1093/hropen/hoac022" ---

Registries and Reporting · National Registry Data

ART in Europe, 2017: results generated from European registries by ESHRE

Wyns C et al., 2021 Human Reproduction Open

--- title: "ART in Europe, 2017: results generated from European registries by ESHRE" source_file: "eshre-eim-2017-source.pdf" pages: 17 extracted_date: "2026-04-24" figures_extracted: 3 tables_extracted: 5 review_flags: 7 journal: "Human Reproduction Open" volume: "Vol.00, No.0" pages_range: "1-17" year: 2021 doi: "10.1093/hropen/hoab026" authors: "Wyns C, De Geyter Ch, Calhaz-Jorge C, Kupka MS, Motrenko T, Smeenk J, Bergh C, Tandler-Schneider A, Rugescu IA, Vidakovic S, Goossens V" consortium: "European IVF-Monitoring Consortium (EIM) for ESHRE" ---

Registries and Reporting · Cross-Registry Comparison

ART in Europe, 2016: results generated from European registries by ESHRE

Wyns C et al., 2020 Human Reproduction Open

--- title: "ART in Europe, 2016: results generated from European registries by ESHRE" source_file: "eshre-eim-2016-source.pdf" pages: 17 extracted_date: "2026-04-24" figures_extracted: 3 tables_extracted: 5 review_flags: 2 citation: "Wyns C et al. ART in Europe, 2016: results generated from European registries by ESHRE. Hum Reprod Open. 2020;2020(3):hoaa032. doi:10.1093/hropen/hoaa032" ---

Registries and Reporting · National Registry Data

ART in Europe, 2015: results generated from European registries by ESHRE

De Geyter C et al., 2020 Human Reproduction Open

--- title: "ART in Europe, 2015: results generated from European registries by ESHRE" source_file: "eshre-eim-2015-source.pdf" pages: 17 extracted_date: "2026-04-24" figures_extracted: 3 tables_extracted: 5 review_flags: 2 review_flags_resolved: 2 review_flags_corrected: 1 review_flags_confirmed: 0 review_flags_unreadable: 1 doi: "10.1093/hropen/hoz038" journal: "Human Reproduction Open" year: 2020 authors: "De Geyter C, Calhaz-Jorge C, Kupka MS, Wyns C, Mocanu E, Motrenko T, Scaravelli G, Smeenk J, Vidakovic S, Goossens V" --- Human Reproduction Open, pp. 1–17, 2020 doi:10.1093/hropen/hoz038 **human reproduction open — ESHRE PAGES**

Evaluation · Prevalence and Incidence

Fertility and infertility: Definition and epidemiology

Vander Borght M et al., 2018 Clinical Biochemistry

Infertility is a disease characterized by the failure to establish a clinical pregnancy after 12 months of regular and unprotected sexual intercourse. It is estimated to affect between 8 and 12% of reproductive-aged couples worldwide. Males are found to be solely responsible for 20-30% of infertility cases but contribute to 50% of cases overall. Secondary infertility is the most common form of female infertility around the globe, often due to reproductive tract infections. The three major factors influencing the spontaneous probability of conception are the time of unwanted non-conception, the age of the female partner and the disease-related infertility. The chance of becoming spontaneously pregnant declines with the duration before conception. The fertility decline in female already starts around 25-30 years of age and the median age at last birth is 40-41 years in most studied populations experiencing natural fertility. The disease-related infertility may affect both genders or be specific to one gender. The factors affecting both genders' fertility are hypogonadotrophic hypogonadism, hyperprolactinemia, disorders of ciliary function, cystic fibrosis, infections, systemic diseases and lifestyle related factors/diseases. Premature ovarian insufficiency, polycystic ovary syndrome, endometriosis, uterine fibroids and endometrial polyps may play a role in female infertility. Male infertility may be due to testicular and post-testicular deficiencies. Semen decline that has been observed over the years, endocrine disrupting chemicals and consanguinity are other factors that may be involved.

Registries and Reporting · National Registry Data

ART in Europe, 2014: results generated from European registries by ESHRE

De Geyter C et al., 2018 Human Reproduction

--- title: "ART in Europe, 2014: results generated from European registries by ESHRE" source_file: "eshre-eim-2014-source.pdf" doi: "10.1093/humrep/dey242" journal: "Human Reproduction, pp. 1-16, 2018" pages: 16 extracted_date: "2026-04-24" figures_extracted: 3 tables_extracted: 5 review_flags: 3 authors: "Ch. De Geyter, C. Calhaz-Jorge, M.S. Kupka, C. Wyns, E. Mocanu, T. Motrenko, G. Scaravelli, J. Smeenk, S. Vidakovic, V. Goossens" ---

Registries and Reporting · National Registry Data

Assisted reproductive technology in Europe, 2013: results generated from European registers by ESHRE

Calhaz-Jorge C et al., 2017 Human Reproduction

Are there any changes in the treatments involving ART and IUI initiated in Europe during 2013 compared with previ- ous years? An increase in the overall number of ART cycles resulting from a higher number of countries reporting data was evident, the pregnancy rates (PRs) in 2013 remained stable compared with those reported in 2012, the number of transfers with multiple embryos (3+) was lower than ever before yet the multiple delivery rates (DRs) remained unchanged, and IUI activity and success rates were similar to those of last years. Since 1997, ART data in Europe have been collected and reported in 16 manuscripts, published in Human Reproduction. STUDY DESIGN, SIZE, Retrospective data collection of European ART data by the European IVF-monitoring Consortium for ESHRE. Data for cycles between 1 January and 31 December 2013 were collected from National Registers, when existing, or on a voluntary basis by personal information. PARTICIPANTS/MATERIALS, SETTINGS, From 38 countries (+4 compared with 2012), 1169 clinics reported 686 271 treatment cycles including 144 299 of IVF, 330 367 of ICSI, 154 712 of frozen embryo replacement (FER), 40 244 of egg donation (ED), 247 of IVM, 9791 of PGD/PGS and 6611 of frozen oocyte replacements. European data on intrauterine insemination using husband/ partner’s semen (IUI-H) and donor semen (IUI-D) were reported from 1095 IUI labs in 22 countries. A total of 175 467 IUI-H and 43 785 IUI-D cycles were included. MAIN In 17 countries where all clinics reported to their ART register, a total of 374 177 ART cycles were performed in a population of around 310 million inhabitants, corresponding to 1175 cycles per million inhabitants (range, 235–2703 cycles per million inhabitants). † ESHRE Pages content is not externally peer reviewed. This manuscript has been approved by the Executive Committee of ESHRE. EIM Committee 2013–2015: chairman: C.C-J.; chairman elect: C.D.; past chairman: M.K. members: J.d.M., K.E., E.M., T.M., G.S., C.W. and V.G. is a science manager at ESHRE Central Office, Brussels. See also Appendix for contributing centres and contact persons representing the data collection programmes in the participating European countries. The main results of this report were presented at the annual ESHRE congress in Helsinki, July 2016. ‡ © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com For all IVF cycles, the clinical PRs per aspiration and per transfer were stable with 29.6% (29.4% in 2012) and 34.5% (33.8% in 2012), respectively. For ICSI, the corresponding rates also were stable with 27.8% (27.8% in 2012) and 32.9% (32.3% in 2012). In FER-cycles, the PR per thawing/warming increased to 27.0% (23.1% in 2012). In ED cycles, the PR per fresh transfer increased to 49.8% (48.4% in 2012), to 38.5% (35.9% in 2012) per thawed transfer, and to 46.4% for transfers after FOR (45.1% in 2012). The DRs after IUI remained stable at 8.6% (8.5% in 2012) after IUI-H and was slightly lower after IUI-D (11.1% versus 12.0% in 2012). In IVF and ICSI cycles, 1, 2, 3 and 4+ embryos were transferred in 31.4, 56.3, 11.5, and 1.0% of the cycles, respectively (corresponding numbers were 30.2, 55.4, 13.3 and 1.1% in 2012). The proportions of singleton, twin and triplet deliveries after IVF and ICSI (added together) were 82., 17.5 and 0.5%, respectively, resulting in a total multiple DR of 18.0% compared to 17.9% in 2012. In FER-cycles, the multiple DR was 12.8% (12.5% twins and 0.3% triplets), nearly the same as in 2012 (12.5, 12.2 and 0.3% respectively). Twin and triplet DRs associated with IUI cycles were 9.5%/0.6% and 7.5%/0.3%, following treatment with husband/donor semen, respectively. LIMITATIONS, The method of reporting varies among countries, and registers from a number of countries have been unable to provide some of the relevant data such as initiated cycles and deliveries.