IVF and IUI treatment cycles increase across Europe, along with stable pregnancy rates

Women in Europe are receiving more cycles of in vitro fertilization (IVF) and intrauterine insemination (IUI), according to data presented today at the ESHRE 40th Annual Meeting in Amsterdam.

Preliminary data from the ESHRE European IVF Monitoring (EIM) Consortium reveals a steady and progressive rise in the use of Assisted Reproductive Technology (ART). In 2021, a total of 1,103,633 ART treatment cycles were reported by 1,382 clinics across 37 European countries—a 20% increase from the 919,364 cycles reported in 2020, keeping in mind that this was the year COVID affected the number of treatment cycles.

Of these 2021 treatment cycles, there were 153,191 IVF, 418,069 intracytoplasmic sperm injection (ICSI), 368,464 frozen embryo replacement, 78,432 preimplantation genetic testing, 79,510 egg donations, 415 in vitro maturation of oocytes, and 5,552 cycles with frozen oocyte replacement. In addition, data from 1,441 institutions reported 148,194 IUI treatments where the partner's semen was used (31 countries) and 48,583 IUI treatments where donor semen was used (23 countries). In total, 28,768 fertility preservation interventions, including oocyte, ovarian tissue, semen, and testicular tissue banking, were reported from 15 countries.

Clinical pregnancy rates per aspiration and per transfer remained similar in 2021 and 2020 for IVF (26.3% and 33.5 % in 2021 versus 25.4% and 33.2% in 2020) and for ICSI (23.9% and 33.5% in 2021 versus 25.2% and 33.0% 2020). Pregnancy rates per transfer for frozen embryo replacement with patients' own embryos were slightly higher in 2021 (37.0%) versus 2020 (36.0%), as were pregnancy rates per fresh embryo transfer from egg donations (53.1% in 2021 versus 51.3% in 2020), while for frozen oocyte replacements the number decreased slightly (45.5% in 2021 versus 45.7% in 2020).

This reflects a 3.98% increase in the use of one embryo per transfer, rising from 57.9% in 2020 to 60.5% in 2021. The proportion of singleton, twin, and triplet deliveries was 90.4%, 9.5%, and 0.1% in 2021, respectively, compared to 88.9%, 10.9%, and 0.2% in 2020. Twin and triplet delivery rates after frozen embryo replacement were 6.9% and 0.1%, respectively, compared to 7.9% and 0.1% in 2020.

The lead author, Dr. Jesper Smeenk of Elisabeth-TweeSteden Hospital in Tilburg, Netherlands, stated, "The 25th ESHRE report on ART and IUI shows a continuous increase of reported treatment numbers and medically assisted reproduction (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."

Professor Dr. Karen Sermon, Chair of ESHRE, added, "This report underscores the significance of collaborative efforts and standardized reporting in advancing reproductive medicine. By enhancing data collection practices, we aim to elevate clinical standards and patient outcomes across Europe."

Data collection and reporting

The ESHRE EIM report represents the largest data collection on medically assisted reproduction in Europe. Since 1997, ART data aggregated by national registries, clinics, or professional societies has been collected and analyzed by the EIM. This year's data, covering treatments from January 1 to December 31, 2021, were provided by national registries or medical associations from 37 European countries.

The authors note in their presentation that the findings should be interpreted with caution, as the methods of data collection and levels of completeness of reported data vary among European countries.