Globally, one in six couples experience problems conceiving naturally. The reasons are evenly distributed between men and woman, with around 10 per cent of couples having no medical reason. Infertility is linked to lifestyle factors such as smoking, bodyweight and stress. In particular, the increasing age of women in relation the desire to have children often makes the use of artificial insemination necessary.
Since the birth of the fist IVF baby in 1978, more than 8 million ‘test tube’ babies have been born worldwide, with most treatments in women between the ages of 30 and 39 years.
Europe leads the way in artificial insemination! Around 50 per cent of IVF treatments performed worldwide are performed in Europe. In 2014, almost 800,000 treatment cycles were performed across 39 European countries. Compare this with 150,000 cycles in the US and 65,000 cycles in Australia and New Zealand. Unfortunately, China does not report statistics to the international register. The number of treatment cycles has increased by 5 to 10 per cent per year in recent years, and growth is currently showing signs of slowing.
In 2014, with more than 100,000 IVF cycles, Spain was by far the most active country in Europe in terms of artificial insemination. In France 90,000, in Germany 80,000, in Italy 69,000 and in Austria 8,000 IVF cycles were performed.
The most active individual countries in the world are Japan (368,000 cycles in 2013) and the USA. It is estimated that China currently performs around 800,000 cycles per year.
Around 1.5 million IVF cycles are reported worldwide every year, resulting in 333,000 births. It is believed that registered cycles make up about 70 per cent of all treatments. It is estimated there are around 2.4 million cycles per year, during which 500,000 babies are born.
The global need for artificial insemination is estimated to sit at 1,500 cycles per million inhabitants annually. In Belgium, the Czech Republic, Denmark, Estonia, Greece and Slovenia, more than 4 per cent of all babies born were conceived using artificial insemination. In contrast, this is estimated to be just over 1% of total births in the USA.
There are differences between countries and the number of embryos transferred which result in multiple births. However, there is a trend towards fewer embryo transfers. The average total number is 1.81 embryos per transfer. In Europe, the twin rate per transfer has fallen from 26.9% in 2000 to 17.5% in 2014. Sweden has the lowest multiple birth rate in the world. A single embryo is transferred in more than two thirds of all cases.
In Europe, the average pregnancy rate per embryo transfer in 2014 was 35% after IVF, 33% after ICSI and 30% after a frozen embryo transfer and 59% after egg donation. The rates are higher in patients under 35.
The most common technique is ICSI. Overall, ICSI accounts for around two thirds of all treatments worldwide, conventional IVF one third. However, these proportions vary greatly from country to country, even if the outcome rates are comparable for each technique. The success rate of frozen embryo transfer is increasing in Europe, as is the number of frozen cycles.
Overstimulation syndrome (OHSS) is the most common complication associated with artificial insemination, with an incidence rate of 1 per cent.