The calculation was made for a presentation at the congress from ICMART (International Committee for Monitoring Assisted Reproductive Technologies) and was based on the number of IVF and ICSI treatment cycles recorded worldwide up to 2008 with estimations added for the following three years. The cumulative total of births was put at 4.6 million last year, and this year has now reached an approximate total of 5 million.
Commenting on this remarkable milestone, Dr David Adamson, from Fertility Physicians of Northern California, USA, and Chairman of ICMART, said: "It means that this technology has been highly successful in treating infertile patients. Millions of families with children have been created, thereby reducing the burden of infertility.
"The technology has improved greatly over the years to increase pregnancy rates. The babies are as healthy as those from other infertile patients who conceive spontaneously. The technology is available globally in many different cultures. The major barriers to access are economic, and societal in some situations. With these accomplishments as a technology, and with recognition of Professor Robert Edwards as a Nobel Laureate, IVF is firmly established now in the mainstream of medicine."
Other ICMART data indicate that around 1.5 million ART cycles are now performed globally each year, producing around 350,000 babies. This number continues to rise. The two most active countries of the world are the USA and Japan, but the most active region by far is Europe.
The picture in Europe
The latest European data to be presented at the ESHRE congress are for 2009, and show that demand for treatment - as expressed in treatment cycles performed in European countries - continues to grow, from 532,260 in 2008 to 537,287 in 2009.
The average availability of ART in Europe is close to 1000 cycles/million inhabitants, but this figure varies greatly between countries and is largely dependent on local state funding policies. Availability in Europe is greater than in the USA but less than in Australia.
Dr Anna Pia Ferraretti, chairman of ESHRE's IVF Monitoring Consortium, said that the global need for ART is estimated to be at least 1500 cycles/million population per year, a figure only seen in Denmark (2726 cycles/million), Belgium (2562 cycles), Czech Republic (1851 cycles), Slovenia (1840 cycles), Sweden (1800 cycles), Finland (1701 cycles) and Norway (1780 cycles). Countries with much lower availability included Austria (747 cycles/million), Germany (830 cycles), Italy (863 cycles) and UK (879 cycles).
Success rates from a single "fresh" treatment cycle of IVF and ICSI - as first indicated in data for 2008 presented last year - seem to have stabilised, at around 32% pregnancy rate per embryo transfer (and 28% per aspiration). Dr Ferraretti said there had been a notable decline in the number of embryos transferred, with cumulative delivery rates, which include the transfer of frozen/thawed embryos from the same stimulation cycle, now representing "the best indicator of outcome". By using this endpoint, she explained, delivery rates can increase substantially while maintaining a very low multiple rate.
On this contentious question of multiple pregnancies, Dr Ferraretti said: "The overall trend in Europe of transferring fewer embryos continues. We found in 2009 that, compared with previous years, fewer three-embryo transfers and more single embryo transfers were performed. As a result of this trend, ART triplets have fallen below 1%, and, for the first time, the twin delivery rate was below 20% (19.6%)."
Additional comments on the global estimate of 5 million babies"Five million babies are a clear demonstration that IVF and ICSI are now an essential part of normalised and standardised clinical therapies for the treatment of infertile couples. Many aspects have changed since the early days of IVF, especially the results in terms of babies born, but there is still room for improvement. Our objective is the birth of single healthy baby and this can be achieved though the optimisation of both clinical and embryological performance."
Dr Anna Veiga, Chairman of ESHRE, and Scientific Director, Dexeus University Institute, Barcelona"I remember well the time of Louise's birth, and also transferring the embryo that became her sister – both of whom are now mums in their own right. The 5 million milestone not only justifies all the legal and moral battles, the ethical debates and hard-fought social approval, it is also a testament to the great scientists and doctors who have worked so hard to improve the treatment of patients, and to the patients themselves who have put their faith in us. It is a moment of pride for our unique branch of medical science, and a point to reflect on how we must continue to fight for our patients where there still remain barriers to treatment."
Dr Simon Fishel, Managing Director CARE Fertility, UK, and a member of the Edwards and Steptoe group in Cambridge responsible for the birth of Louise Brown"With ICSI now responsible for more fertilisations than conventional IVF, it seems reasonable to suppose that a good proportion of these 5 million babies will have been conceived by ICSI. When we developed the technique 20 years ago we could never have imagined that its success would be so great, nor that the world would welcome so many babies in such a short time. At 5 million babies and counting, I think we can now fairly say that the vast majority of fertility problems - whether of male or female origin - can be successfully and safely treated by IVF or ICSI."
Professor André Van Steirteghem, who with the VUB Brussels group pioneered the development of ICSI as a successful treatment for male infertility and reported the first birth in 1992.
Note: When obtaining outside comment, journalists are requested to ensure that their contacts are aware of the embargo on this release.
The 28th Annual Meeting of ESHRE, the world's largest event in reproductive science and medicine, is taking place in Istanbul from 1-4 July 2012
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