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

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.

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.

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.

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).

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 transparency and vigilance in the field of reproductive medicine.