Assisted reproductive technology outcome in United States of America and Australia with New Zealand: comparison of annual reports 2005–2016

Abstract

In vitro fertilization can be considered as causative factor of increasing rate of multiple pregnancies. Analysis of factors contributing to reduction in the percentage of multiple pregnancies may contribute to overall improvement of ART results. We compared annual reports from The Australian and New Zealand Assisted Reproduction Database and US National Summary Reports presented by The Centers for Disease Control and Prevention. The aim of this study was to analyze results of ART outcomes in two countries presenting opposite approach to ART, particularly to number of transferred embryos and number of eSETs (elective single embryo transfers). We found significant increase in total number of initiated cycles and transfers with significant shift toward frozen cycles and transfers in both countries. Percentage of eSET increased while average number of embryos transferred per one transfer decreased significantly in both countries without significant difference between countries. We also noticed significant decrease in the rate of multiple pregnancies and percentage of pregnancies resulting in triplets in Australia with New Zealand. Decreasing number of multiple pregnancies and higher percentage of transfers and pregnancies resulting in singleton live birth are the changes in ART politics found in our analysis. United States of America have more significant changes toward eSET, although Australia and New Zealand have significantly higher percentage of eSET from the beginning of analysis.

摘要

体外受精可能是多胎妊娠率升高的原因之一。分析导致多胎妊娠率降低的因素可能有助于全面改善抗逆转录病毒治疗的结果。我们比较了澳大利亚和新西兰辅助生殖数据库的年度报告和美国疾病控制和预防中心提交的国家总结报告。本研究的目的是分析两个采用相反ART方法特别是移植胚胎数量和eSET（选择性单胚胎移植）数量的国家ART治疗结局。我们发现, 两国启动的周期和移植的总数显著增加, 并显著转向冷冻的周期和移植。两国eSET百分率均显著上升, 而平均每次移植胚胎数均显著下降, 但国家间差异不显著。我们还注意到多胎妊娠率和妊娠导致的三胞胎百分比在澳大利亚和新西兰显著下降。在我们的分析中发现ART策略的改变, 多胎妊娠数量的减少, 移植和妊娠比例的提高导致了单胎活产。美国对eSET的态度发生了更大的变化, 尽管澳大利亚和新西兰从分析开始就有明显更高的eSET百分比。

Keywords:

• ART outcome
• in vitro fertilization
• single embryo transfer
• live birth rates

Acknowledgements

The authors wish to thank to Dr Adam Czyzyk for help in data analysis, Dr Ewa Milewska for help in data analysis, Dr Marcin Stankiewicz for information about fertility treatment organization in Australia and New Zealand.

Disclosure statement

The authors report no conflicts of interest.