Assisted reproductive technology in Australia & New Zealand 2012

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Use of assisted reproductive technology treatment

There were 70,082 assisted reproductive technology (ART) treatment cycles performed in Australia and New Zealand in 2012 (64,905 and 5,177 respectively), representing an increase of 5.8% for Australia and a decrease of 0.2% for New Zealand on 2011. This represented 13.7 cycles per 1,000 women of reproductive age (15–44 years) in Australia, compared with 5.7 cycles per 1,000 women of reproductive age in New Zealand. Women used their own oocytes or embryos (autologous) in 95.2% of treatments, and 34.8% of all cycles used frozen/thawed embryos.

There were 36,171 women who undertook 66,710 autologous fresh and/or thaw cycles in Australia and New Zealand in 2012. On average, 1.8 cycles per woman were undertaken in 2012, with more cycles per woman in Australia (1.9 cycles per woman) than in New Zealand (1.5 cycles per woman). There was a marked increase in cycles where preimplantation genetic diagnosis was performed, from 2.0% of cycles in 2011 to 3.7% of cycles in 2012.

Women’s age

The average age of women undergoing autologous cycles was 35.8. In contrast, the average age of women undergoing ART treatment using donor oocytes or embryos was approximately five years older at 40.5. Approximately one in four (25.3%) women who underwent an autologous cycle in 2012 was aged 40 or older. The average age of male partners was 38.2, with one-third (35.4%) aged 40 or older.

Treatment outcomes and number of babies

Of the 70,082 initiated cycles, 23.9% resulted in a clinical pregnancy, and 17.9% in a live delivery (the birth of at least one liveborn baby). The live delivery rate per initiated fresh cycle was 16.7% and per fresh embryo transfer cycle was 22.8%. The live delivery rate per initiated thaw cycle was 20.5% and per thaw embryo transfer cycle was 22.2%.

There was a higher live delivery rate in younger women. For women aged under 30, the live delivery rate was 26.0% for both autologous fresh and thaw cycles. For women aged over 44, the live delivery rate was 0.9% and 4.6% for autologous fresh and thaw cycles respectively.

There were 13,590 babies born (including 13,312 liveborn babies) following ART treatment in 2012. Of these, 12,304 (90.5%) were from Australian clinics and 1,286 (9.5%) from New Zealand clinics. Over three-quarters of the liveborn babies (76.4%) were full-term singletons of normal birthweight.

Cycle-specific success rates

Since 2009, ANZARD has included data items that make it possible to follow a woman’s successive ART treatment cycles. A cohort of 16,565 women was followed from the start of their first autologous fresh cycle during 2009, through subsequent fresh and thaw cycles until December 2012 or until they achieved a live delivery. The cycle-specific live delivery rate for all women was 21.1% in their first cycle, and apart from an initial drop from cycle one to cycle two, the live delivery rate remained stable at around 14–17% for the next seven cycles. One-quarter of women did not proceed with a subsequent treatment cycle when they did not achieve a live birth.

Trends in ART procedures

In the last five years there has been a shift from day 2–3 embryo (cleavage stage) transfers to day 5–6 embryo (blastocyst) transfers and an increased use of intracytoplasmic sperm injection (ICSI). The proportion of blastocyst transfer cycles increased from 42.0% in 2008 to 59.8% in 2012, and the proportion of ART treatment cycles that used ICSI increased from 59.1% of cycles in 2008 to 64.7% in 2012.

The proportion of fresh cycles that reached embryo transfer has decreased from 76.6% to 72.0% of initiated cycles in the last five years. The proportion of ART cycles involving thaw embryos remained stable in the last five years at around 36% of initiated cycles. In the last five years the live delivery rate per initiated fresh cycle ranged from 16.4% to 18.1%, while the live delivery rate per initiated thaw cycle increased from 16.3% to 20.3%.

Multiple birth trends

Acontinuing trend in ART treatment in Australia and New Zealand has been the reduction in the rate of multiple deliveries, with a decrease from 8.4% in 2008 to 6.5% (6.6% for Australia and 5.2% for New Zealand) in 2012. This was achieved by clinicians and patients shifting to single embryo transfer, with the proportion increasing from 67.8% in 2008 to 76.3% in 2012. Importantly, this decrease in the multiple delivery rate was achieved while clinical pregnancy rates remained stable at around 23% per initiated cycle.

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