Page 7 - FSANZ SPRING -2021

IVF success rates continue upward trend
IVF success rates have improved significantly over the past 10 years, according the latest Assisted Reproductive Technology in Australia and New Zealand 2019 (ANZARD) report from the University of New South Wales.
The live birth rate per initiated IVF cycle in women using their own eggs has increased by 18 per cent overall, with even bigger improvements in older age groups.
“For example, in women aged 35 to 39, the live birth rate per cycle started has increased from 19 per cent to 23 per cent, representing a 20 per cent relative increase in success rates,” said Professor Georgina Chambers, lead author of the ANZARD report.
“For those aged 40 to 44, the live birth rate has increased to 10 per cent, representing a 27 per cent increase in success rates over the past 10 years.”
There were 88,929 initiated IVF cycles in 2019, a 6.2 per cent increase on 2018 figures in Australia. Not all cycles reach embryo transfer, but those that do also resulted in significant improvements.
The overall live birth rate per embryo transfer has increased from 22 per cent in 2010 to 28 per cent in 2019. It was higher in younger women – the live birth rate per embryo transfer was 35.1 per cent for fresh cycles and 34.1 per cent for thaw cycles in women aged between 30 and 34 years, whereas in women older than 44 years, the live birth rate per embryo transfer was 1.7 per cent for fresh cycles and 9.2 per cent for thaw cycles.
The ANZARD report is funded by the Fertility Society of Australia and New Zealand (FSANZ) and contains data from all 95 IVF clinics operating in the two countries.
In 2019 – the most recent year for which data is available – there were 16,310 babies born through IVF treatment in Australia and New Zealand.
Dr Petra Wale, a senior embryologist and Vice President of FSANZ said: “The improved success rates are due to many factors including advancements in laboratory techniques and improvements in the overall management of couples experiencing infertility, such as lifestyle interventions, improved diagnostic capabilities and, in some cases, surgery prior to IVF.
“Every aspect of an IVF cycle – from ovarian stimulation protocols, the culture media that embryos are grown in, to the selection of the best embryo at optimal stage of development – have seen incremental improvements over the past decade.”
The biggest improvements occurred in live birth rates in frozen embryo transfers versus fresh transfers. There has been a 50 per cent increase over the past decade in the live birth rate per frozen embryo transfer from 20 per cent in 2010 to 30 per cent in 2019. Over the same period, the live birth rate following fresh transfers has increased from 24 per cent to 25 per cent.
FSANZ President, Professor Luk Rombauts, said there has been a shift from fresh embryo transfer to frozen embryo transfer.
“Doing this allows us to transfer the embryo into the womb when the body is more receptive, and the evolution of rapid freezing techniques, or vitrification, allows us the cryopreserve embryos more effectively than older freezing methods,” he said.
The multiple birth rate in Australia and New Zealand – the proportion of twins and triplets born through IVF – has decreased from 7.9 per cent in 2010 to 2.9 per cent in 2019. This is another decrease from the previous year’s record low.
This outcome has been driven by the increased proportion of IVF cycles where only a single embryo is transferred, up from 70 per cent in 2010 to 92 per cent in 2019.
“This continuing trend in the very low multiple birth rate is quite extraordinary, and we are really proud that Australia and New Zealand are among the safest countries in the world to have IVF,” Professor Rombauts said.
Earlier this year, the UNSW developed the YourIVFSuccess.com.au website that features a Patient Estimator allowing patients to estimate their chances of successfully having a baby using IVF based on their individual characteristics. It also includes a searchable database of the success rates for all accredited IVF clinics in Australia.
Key outcomes from the 2019 ANZARD report
• there were 88,929 assisted reproductive technology (ART) treatment cycles reported from Australian and New Zealand clinics in 2019 (81,049 and 7,880 respectively) representing increases of 6.2 per cent
in Australia and 2.0 per cent in New Zealand from 2018;
• of the 88,929 initiated ART cycles, there were 16,310 live births;
• women used their own eggs in nearly 95 per cent of cycles in 2019 – 57.9 per cent were fresh cycles and 36.7 per cent were thaw cycles;
• the live birth rate per initiated cycle was 16.5 per cent for autologous fresh (excluding freeze-all) cycles and 28.9 per cent for autologous frozen/thaw cycles;
• single embryo transfer rates have increased from 82.9 per cent of embryo transfer procedures in 2015 to 91.9 per cent in 2019; and
• the multiple birth rate has decreased from 4.4 per cent in 2015 to 2.9 per cent in 2019.
Data presented in the report is managed by the National Perinatal Epidemiology and Statistics Unit (NPESU) within UNSW’s Centre for Big Data Research in Health and School of Women’s and Children’s Health.
5