Research Methods · Measurement and Statistics

EuMAR stakeholder engagement: an analysis of medically assisted reproduction (MAR) data collection practices in EU countries†

Achótegui Sebastián E, Calhaz-Jorge C, De Geyter C, Ebner T, Plancha CE, Goossens V, Pinborg A, Polyzos NP, Rossignoli L, Rugescu IA, Smeenk J, Strowitzki T, Tassot J, Mocanu EV, Vermeulen N, Wyns C, Magli MC

Published November 2024 Human Reproduction
DOI 10.1093/humrep/deae209 PMID 39276145 PMC PMC11532600

RRM Academy Synopsis

EU Countries Vary Widely in Fertility Treatment Data Tracking

Researchers surveyed the agencies that track fertility treatment data in 26 of 27 EU countries. They followed up with interviews. Five countries have no national registry of fertility treatment cycles at all. The rest differ widely in what they track and whether it is required by law.

Key Findings

  • 21 of the 26 responding EU countries reported having a national registry that tracks fertility treatment cycles; five (Estonia, Ireland, Latvia, Luxembourg, and Slovenia) reported they do not.
  • Reporting to the national registry is required by law in 16 countries and voluntary in five: Germany, Greece, Poland, Sweden, and the Netherlands.
  • Among the 21 countries with a registry, 13 record data cycle by cycle; eight collect only combined yearly totals for the whole country.
  • Only seven countries reported capturing 100% of fertility treatments performed nationally: Bulgaria, Italy, Malta, Poland, Portugal, Romania, and Sweden.
  • 26 of 27 EU countries completed the survey; three, Austria, Croatia, and Denmark, later decided not to continue engaging with the new EU-wide registry project.

Interpretation

The document is a survey and interview study. It is not a clinical trial. National institutions responsible for fertility treatment data in 26 of 27 EU countries answered a 35-question survey in 2023. 23 countries also gave a follow-up interview. Officials reviewed their country's summary before it was final. The results describe how each country's data system works: what it requires, what it records, and how complete it is. They do not measure how well any treatment worked. Coverage figures were self-reported. No outside body verified them. The study says nothing about pregnancy or birth outcomes. The survey maps the data systems a future EU-wide registry would need to connect.

RRM Context

Restorative reproductive medicine gives patients their own cycle chart, updated in real time. The survey shows how much fertility treatment data in Europe still depends on registries built after the fact. Many have gaps. It is often hard to compare outcomes across countries, or even to confirm how complete one country's own numbers are. A patient's own chart cannot close that gap. But it is one record no incomplete registry can lose.

Abstract

Study Question

What are the current national medically assisted reproduction (MAR) data collection systems across EU Member States, and how can these countries contribute to a unique, cycle-by-cycle registry for the European Monitoring of Medically Assisted Reproduction (EuMAR) project?

Summary Answer

The study identified significant variation in MAR data collection practices across Member States, with differences in data types, collection methods, and reporting requirements; the EuMAR project emerges as an opportunity to enhance data standardization and improve MAR data collection in the EU.

What Is Known Already

There is a need for new approaches in MAR data collection that include long-term and cross border follow-up. The EuMAR project intends to establish a unified, cycle-by-cycle registry of data on MAR treatments in EU countries, from which accurate cumulative outcomes can be calculated.

Study Design, Size, Duration

This cross-sectional study involved a survey and interviews with stakeholders from 26 EU Member States conducted in 2023 over a period of seven months.

Participants/Materials, Setting, Methods

Representatives from national competent authorities and professional associations involved in MAR data collection in EU countries were invited to complete the survey and interviewed to assess current data flows, information requirements, and their interest in the EuMAR project.

Main Results and the Role of Chance

Half of the participating countries reported having a national MAR registry with cycle-by-cycle data (n = 13), while 31% reported having a national registry with aggregated data (n = 8) and 19% reported having no national registry (n = 5). Of the countries with a national cycle-by-cycle registry, eight countries collect identifiable data, five countries collect pseudonymized data, and one country collects fully anonymized data. Informed consent is required in 10 countries. The main advantages that participants expected from a European registry like EuMAR were the possibility of obtaining national statistics in the absence of a national registry and improving the calculation of cumulative outcomes.

Limitations, Reasons for Caution

The results of the study are based on self-reported data, which may be subject to bias, however, the validity of the collected information was verified with different means, including follow-up calls for clarifications and sharing final transcript reports. The feasibility of the proposed data flow models will be tested in a pilot study.

Wider Implications of the Findings

Despite the heterogeneity of data collection practices across EU countries, the results show that stakeholders have high expectations of the benefits that the EuMAR registry can bring, namely the improvement of data consistency, cross-border comparability, and cumulative live birth rates, leading to better information for patients, health care providers and policy makers.

Study Funding/Competing Interests

The EuMAR project was co-founded by ESHRE and the European Commission (101079865-EuMAR-EU4H-2021-PJ2). No competing interests were declared.

Trial Registration

N/A.

Topics

By this author

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Research Methods › Measurement and Statistics › Research Tooling and Reproducibility · Assisted Reproduction › Registries and Reporting › National Registry Data · Ethics and Policy › Policy and Regulation › Professional Standards
Elena Achótegui Sebastián, Carlos Calhaz-Jorge, Christian De Geyter, Thomas Ebner, Carlos E Plancha, Veerle Goossens, Anja Pinborg, Nikolaos P Polyzos, Laura Rossignoli, Ioana Adina Rugescu, Jesper Smeenk, Thomas Strowitzki, Johanna Tassot, Edgar V Mocanu, Nathalie Vermeulen, Christine Wyns, M Cristina Magli
E Sebastián, C Calhaz-Jorge, C Geyter, Tom Ebner, T Ebner, C Plancha, V Goossens, A Pinborg, N Polyzos, L Rossignoli, I Rugescu, J Smeenk, Tom Strowitzki, T Strowitzki, J Tassot, E Mocanu, N Vermeulen, Chris Wyns, C Wyns
PMID 39276145 39276145 DOI 10.1093/humrep/deae209 10.1093/humrep/deae209 Achótegui Sebastián et al. 2024, Achótegui Sebastián 2024