Projecting future utilization of medically assisted fertility treatments

Abstract

This study estimates the future utilization of medically assisted fertility treatments in Australia, focusing on assisted reproductive technologies (ARTs), intrauterine insemination (IUI), and ovulation induction. A multistate cohort component population projection model is used to determine future fertility rates from 2016 to 2026 by age and education level. These are combined with information on recent trends in use and success rates to indirectly estimate future age-specific probabilities of fertility treatment utilization. The number of ART cycles is expected to increase by 61 per cent between 2016 and 2026 if treatment success rates remain at 2015 levels, or by 34 per cent if recent improvements in ART success rates continue. The model also predicts that numbers of IUI cycles and ovulation induction cycles will decrease by 17 and 3 per cent, respectively. This research confirms the importance of including both technological improvements and socio-demographic changes when predicting future fertility treatment utilization.

Keywords:

• infertility
• assisted reproductive technologies
• postponement
• multistate demography
• projection
• Australia

Notes and acknowledgements

1 Please direct all correspondence to James Raymer, School of Demography, 9 Fellows Road, Australian National University, Acton ACT 2601, Australia; or by E-mail: [email protected]

2 James Raymer and Qing Guan are based in the School of Demography, Australian National University. Robert J. Norman is at the Robinson Research Institute, University of Adelaide, as well as Fertility SA. William Ledger is based in the School of Women’s and Children’s Health, University of New South Wales. Georgina M. Chambers is at the National Perinatal Epidemiology and Statistics Unit, the Centre for Big Data Research in Health, and the School of Women’s and Children’s Health, University of New South Wales.

3 This study was supported by the National Health and Medical Research Council in Australia: [Grant Number APP1104543]. The authors would like to thank Evá Beaujouan, Edith Gray, Heather Booth, and participants in the Australian National University symposium on ‘Reproduction and Family Formation in Australia’ for their comments and suggestions.

4 Disclosure statements: Robert Norman is a clinician at Fertility SA, an IVF group in Adelaide, and a reproductive endocrinologist at the Royal Adelaide Hospital. He is a minor shareholder in an IVF company, where he works as a consultant in reproductive medicine. William Ledger is a shareholder and paid consultant of Virtus Health, a public fertility company. He holds or has applications pending for patents related to fertility treatment. His institution has received research funding on his behalf from Ferring Pharmaceuticals, and he has received sitting fees for membership and Chair positions for a number of government and professional committees relating to fertility treatment, including the Medicare Benefits Schedule (MBS) Taskforce for the Independent Review of Assisted Reproductive Technologies (2017). He has received travel grants and honoraria from Ferring Pharmaceuticals, Swiss Precision Diagnostics, and MSD. Georgina Chambers is the Director of the National Perinatal Epidemiology and Statistics Unit (NPESU) at the University of New South Wales, Sydney. The Fertility Society of Australia funds the NPESU to manage ANZARD and conduct national reporting of ARTs in Australia and New Zealand. She received sitting fees as a member of the Australian Government’s MBS Taskforce for the Independent Review of Assisted Reproductive Technologies (2017). She has also received an institutional research grant unrelated to this study from the Australian Research Council (ARC), for which Virtus Health, a publicly listed IVF company, was the partner organization (2010–13).

ORCID

James Raymer http://orcid.org/0000-0001-6588-8985

Qing Guan http://orcid.org/0000-0003-3516-5975