RRM Academy Synopsis
Sweden's IVF registry reports 22% of fresh cycles ended in delivery
Sweden's national IVF quality registry reports that about 22 of every 100 fresh IVF cycles ended in a delivery. The annual report draws on 11,659 fresh cycles started in 2017 with the couple's own eggs and sperm. The share fell from 27 out of 100 below age 30 to 8 out of 100 at age 42 or older.
Key Findings
- Of 11,659 fresh cycles, 10,943 reached egg aspiration, 8,576 an embryo transfer, 3,004 a clinical pregnancy and 2,516 a delivery; delivery per started cycle was 22%.
- Delivery per started fresh cycle by age: under 30, 27%; 30 to 35, 26%; 36 to 37, 21%; 38 to 39, 13%; 40 to 41, 13%; 42 or older, 8%.
- Delivery per embryo transfer across all ages was 29.3% after fresh transfers and 32.6% after frozen transfers.
- Single embryo transfer made up 83.7% of fresh transfers in 2017, up from 69.6% in 2007, and 98.2% of frozen transfers in 2017.
- A complication was reported in 173 of 11,659 fresh cycles (1.5%), no complication in 78% and no report for 20.5%.
Interpretation
The Q-IVF annual report summarizes registry data on every treatment cycle started at Swedish clinics in 2017, grouped by cycle type and age. A delivery is a live or stillborn birth after 22 completed weeks of pregnancy. The report presents no comparison with untreated couples and no analysis of why the couples were infertile. The authors call delivery per started cycle a potentially misleading measure. Some cycles are not meant to lead to an embryo transfer, such as those that freeze eggs or embryos, so the report mainly gives delivery per embryo transfer. The authors also note that complication reporting began in 2014 and was still incomplete.
RRM Context
IVF bypasses the reproductive system without resolving why conception fails. Restorative reproductive medicine (RRM) starts from diagnosis. RRM clinicians evaluate both partners, find the cause of low fertility and treat it, with cycle charting to guide the evaluation.
Key figures
Clinics and participation, 2017
| Measure | Value | Source |
|---|---|---|
| Total number of IVF clinics active | 18 | Figure 2 |
| Number of publicly run IVF clinics active | 6 | Figure 2 |
| Number of privately run IVF clinics active | 12 | Figure 2 |
| Share of clinics reporting into the registry | 100% | Figure 2 |
Treatment volume, 2017
| Measure | Value | Source |
|---|---|---|
| Total assisted reproduction treatments begun | 22,403 | Table 2 |
| IVF cycles begun using the woman's own eggs | 18,639 | Table 2 |
| IVF cycles begun with donated eggs or sperm | 1,233 | Table 2 |
| Donor insemination treatments begun | 2,170 | Table 2 |
Births and deliveries, 2017
| Measure | Value | Source |
|---|---|---|
| Children born following IVF treatment | 5,137 | Report text |
| Share of all Swedish births attributable to IVF | 4.3% | Report text |
| Total children born alive after any assisted reproduction method | 5,428 | Tables 1, 6, 9 |
| Children born alive from IVF with the woman's own eggs | 4,787 | Tables 1, 6, 9 |
| Children born alive from IVF with donated gametes | 350 | Tables 1, 6, 9 |
| Children born alive from donor insemination | 291 | Tables 1, 6, 9 |
| Total deliveries from any assisted reproduction method | 5,341 | Tables 1, 6, 9 |
| Deliveries from IVF with the woman's own eggs | 4,710 | Tables 1, 6, 9 |
| Deliveries from IVF with donated gametes | 349 | Tables 1, 6, 9 |
| Deliveries from donor insemination | 282 | Tables 9-10 |
IVF outcomes, own gametes 2017
| Measure | Value | Source |
|---|---|---|
| Live birth rate per started cycle, fresh IVF with own eggs | 22% | Figure 9 |
| Live birth rate per embryo transfer, fresh IVF with own eggs | 29.3% | Figure 10 |
| Live birth rate per embryo transfer, frozen transfer with own eggs | 32.6% | Figure 10 |
IVF outcomes by age, own gametes 2017
| Measure | Value | Source |
|---|---|---|
| Live birth rate per embryo transfer, fresh IVF, women under 30 | 39.8% | Figure 10 |
| Live birth rate per embryo transfer, fresh IVF, women aged 38-39 | 17.0% | Figure 10 |
| Live birth rate per embryo transfer, frozen transfer, women aged 38-39 | 30.3% | Figure 10 |
| Live birth rate per embryo transfer, fresh IVF, women 42 and older | 10.4% | Figure 10 |
Fresh IVF treatment funnel, 2017
| Measure | Value | Source |
|---|---|---|
| Fresh IVF cycles started with the woman's own eggs | 11,657 | Figure 5 |
| Share of started stimulation cycles stopped before egg collection | 6% | Fresh-IVF treatment funnel narrative |
| Share of embryo transfer patients with a positive pregnancy test | 40% | Fresh-IVF process funnel section |
| Share of positive pregnancy tests confirmed viable on ultrasound at weeks 7-8 | 87% | Fresh-IVF process funnel section |
| Deliveries resulting from those started fresh IVF cycles | 2,516 | Figure 5 |
Embryo transfer practice, 2017
| Measure | Value | Source |
|---|---|---|
| Share of frozen embryo transfers using blastocyst-stage embryos | 88% | Figures 8a-8b |
| Share of fresh embryo transfers using blastocyst-stage embryos | 31% | Figures 8a-8b |
| Share of frozen, thawed embryo transfers using blastocyst-stage embryos | 98% | Concluding summary on cryopreservation |
Complications, fresh IVF cycles 2017
| Measure | Value | Source |
|---|---|---|
| Overall complication rate among fresh IVF treatments | 1.5% | Table 3 |
| Fresh IVF treatments assessed for complications | 11,659 | Table 3 |
| Hospitalized OHSS cases among fresh IVF treatments | 60 | Table 3 |
| Hospitalized OHSS rate among fresh IVF treatments | 0.5% | Table 3 |
| Bleeding complications among fresh IVF treatments | 10 | Table 3 |
| Infections among fresh IVF treatments | 9 | Table 3 |
| Ovarian torsion cases among fresh IVF treatments | 3 | Table 3 |
Multiple births, 2017
| Measure | Value | Source |
|---|---|---|
| Overall multiple birth rate after IVF | 3.2% | Table 4 |
| Twin birth rate after fresh IVF | 4.0% | Table 4 |
| Triplet birth rate after fresh IVF | 0.1% | Table 4 |
| Twin birth rate after frozen embryo transfer | 2.3% | Table 4 |
IVF with donated gametes, 2017
| Measure | Value | Source |
|---|---|---|
| IVF cycles started using donated eggs | 341 | Table 6 |
| Fresh IVF cycles started using donated eggs | 145 | Table 6 |
| Frozen IVF cycles started using donated eggs | 196 | Table 6 |
| Delivery rate per fresh embryo transfer using donated eggs | approximately 27% | Figure 20 |
| Delivery rate per frozen embryo transfer using donated eggs | 29% | Figure 20 |
| Chance of a live birth after a fresh donor-egg cycle | about 28% | IVF with donated gametes section |
| IVF cycles started using donated sperm | 892 | Table 6 |
| Fresh IVF cycles started using donated sperm | 535 | Table 6 |
| Frozen IVF cycles started using donated sperm | 357 | Table 6 |
| Delivery rate per embryo transfer using donated sperm, fresh and frozen combined | 35% | Figure 19 |
Donor insemination (AID), 2017
| Measure | Value | Source |
|---|---|---|
| Delivery rate per donor insemination attempt | 15.5% | Tables 9-10 |
| Donor insemination attempts performed | 1,817 | Tables 9-10 |
Fertility preservation, 2017
| Measure | Value | Source |
|---|---|---|
| Oocyte freezing procedures performed | 361 | Table 2 |
| Oocyte freezing procedures done for an oncological indication | 102 | Report text |
| Oocyte freezing procedures done for non-medical, social reasons | 250 | Report text |
| Oocyte freezing procedures done for other medical reasons | 9 | Report text |
Trends, donor insemination (AID)
| Measure | Value | Source |
|---|---|---|
| Increase in donor insemination cycles started, from 2016 to 2017 | 365 | AID (insemination with donated sperm) section |
| Increase in donor insemination cycles started in 2016 (context, prior-year comparison, not Sweden's 2017 figure) | about 500 | AID (insemination with donated sperm) section |
Our summary of the report's published figures, each citing its table, figure or section. The full report is at the publisher's link.