Assisted reproductive technology in Europe, 2010: results generated from European registers by ESHRE
Assisted reproductive technology in Europe, 2010: results generated from European registers by ESHRE
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DOI：
10.1093/humrep/deu175
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发表时间：
2014-10-01
影响因子：
6.1
通讯作者：
Goossens, V.
中科院分区：
文献类型：
--
作者：
Kupka, M. S.;Ferraretti, A. P.;Goossens, V.
研究问题：第14期欧洲体外受精监测（EIM）报告介绍了2010年欧洲启动的医学辅助生殖治疗（包括辅助生殖技术（ART）周期和宫内授精（IUI）周期）的结果：与前几年相比，趋势是否有变化？总结回答：尽管报告的国家数量有所波动，但抗逆转录病毒疗法周期的总数继续逐年增加，虽然2010年的怀孕率与2009年报告的怀孕率相似，但多个胚胎移植的数量（三个或更多）进一步下降。什么是已知的：自1997年以来，欧洲的ART数据已被收集并在13篇手稿中报告，发表在《人类生殖》杂志上。EIM Consortium为ESHRE回顾性收集欧洲ART数据;数据收集自2010年1月1日至12月31日期间开始的周期，由各个欧洲国家的国家登记中心收集，参与者/材料设置，方法：在31个国家中，991个诊所报告了550296个ART治疗周期：IVF（125 994）、ICSI（272 771）、冷冻胚胎置换（FER，114 593）、卵子捐献（艾德，25 187）、体外成熟（493）、植入前遗传学诊断/植入前遗传学筛查（6399）和冷冻卵母细胞置换（4859）。欧洲分别有22个和19个国家报告了使用丈夫/伴侣精液（IUI-H）或供体精液（IUI-D）进行IUI的数据。总计176 512例IUI-H（与2009年相比增加8.4%）和38 124例IUI-D（与2009年相比增加了30.4%）。主要结果和机会的作用：在所有诊所都向国家抗逆转录病毒治疗登记处报告的16个国家中，在2.19亿居民中共进行了267120个抗逆转录病毒治疗周期，相当于每百万居民1221个周期。与2009年的比率相比，IVF每次抽吸和每次转移的临床妊娠率分别增加到29.2%和33.2%，ICSI的相应比率也增加到28.8%和32.0%。在FER周期中，每次解冻的妊娠率为20.3%，在艾德周期中，每次新鲜移植的妊娠率为47.4%，每次解冻移植的妊娠率为33.3%。IUI-H组的分娩率为8.9%，IUI-D组为13.8%。在IVF和ICSI周期中，分别有25.7%、56.7%、16.1%和1.5%的人移植了一个、两个、三个和四个或更多个胚胎。IVF和ICSI（联合）后单胎、双胎和三胎分娩的比例分别为79.4%、19.6%和1.0%，导致总多胎分娩率为20.6%，而2009年为20.2%，2008年为21.7%，2007年为22.3%，2006年为20.8%。在FER周期中，多胎分娩率为12.8%（双胎12.5%，三胎0.3%）。与IUI周期相关的双胞胎和三胞胎分娩率分别为9.6/0.5和8.5/0.2%，分别与丈夫和供体精液治疗后，限制，预防的原因：报告的方法是不标准的，在欧洲，但各国之间的差异。此外，一些国家的登记册无法提供一些相关数据，如启动周期和分娩。研究结果的更广泛意义：第14期ESHRE关于ART和IUI治疗的报告显示，欧洲ART治疗周期数持续增加，2010年报告的周期数超过50万。ICSI的使用可能已经达到了一个平台。与2009/2008年相比，IVF和ICSI后的妊娠率和（多胎）分娩率保持相对稳定。多次胚胎移植（三个或更多胚胎）的数量已显示下降。研究资金/竞争利益：该研究没有外部资金;所有费用均由ESHRE承担。没有利益冲突。
STUDY QUESTION: The 14th European IVF-monitoring (EIM) report presents the results of medically assisted reproduction treatments including assisted reproductive technology (ART) cycles and intrauterine insemination (IUI) cycles initiated in Europe during 2010: are there changes in the trends compared with previous years?SUMMARY ANSWER: Despite some fluctuations in the number of countries reporting, the overall number of ART cycles has continued to increase year by year, and while pregnancy rates in 2010 remained similar to those reported in 2009, the number of transfers with multiple embryos (three or more) further declined.WHAT IS KNOWN ALREADY: Since 1997, ART data in Europe have been collected and reported in 13 manuscripts, published in Human Reproduction.STUDY DESIGN, SIZE, DURATION: Retrospective collection of European ART data by the EIM Consortium for ESHRE; data were collected from cycles started between 1st January and 31st December 2010 by the National Registries of individual European countries, or on a voluntary basis by personal information for European countries without a national registry.PARTICIPANTS/MATERIALS SETTING, METHODS: Out of 31 countries, 991 clinics reported 550 296 ART treatment cycles: IVF (125 994), ICSI (272 771), frozen embryo replacement (FER, 114 593), egg donation (ED, 25 187), in vitro maturation (493), preimplantation genetic diagnosis/preimplantation genetic screening (6399) and frozen oocyte replacements (4859). European data on IUI using husband/partner's semen (IUI-H) or donor semen (IUI-D) were reported from 22 and 19 countries, respectively. A total of 176 512 IUI-H (+ 8.4% compared with 2009) and 38 124 IUI-D (+ 30.4% compared with 2009) cycles were included.MAIN RESULTS AND THE ROLE OF CHANCE: In 16 countries where all clinics reported to the national ART registry, a total of 267 120 ART cycles were performed in a population of 219 million inhabitants, corresponding to 1221 cycles per million inhabitants. For IVF, the clinical pregnancy rates per aspiration and per transfer increased to 29.2 and 33.2%, respectively, and for ICSI, the corresponding rates also increased to 28.8 and 32.0%, when compared with the rates of 2009. In FER cycles, the pregnancy rate per thawing was 20.3%; in ED cycles the pregnancy rate per fresh transfer was 47.4% and per thawed transfer 33.3%. The delivery rate after IUI-H was 8.9 and 13.8% after IUI-D. In IVF and ICSI cycles, one, two, three and four or more embryos were transferred in 25.7, 56.7, 16.1 and 1.5%, respectively. The proportions of singleton, twin and triplet deliveries after IVF and ICSI (combined) were 79.4, 19.6 and 1.0%, respectively, resulting in a total multiple delivery rate of 20.6% compared with 20.2% in 2009, 21.7% in 2008, 22.3% in 2007, 20.8% in 2006. In FER cycles, the multiple delivery rate was 12.8% (12.5% twins and 0.3% triplets). Twin and triplet delivery rates associated with IUI cycles were 9.6/0.5 and 8.5/0.2%, following treatment with husband and donor semen, respectively.LIMITATIONS, REASONS FOR CAUTION: The method of reporting is not standardized in Europe but varies among countries. Furthermore registries from a number of countries have been unable to provide some of the relevant data such as initiated cycles and deliveries. Therefore, results should be interpreted with caution.WIDER IMPLICATIONS OF THE FINDINGS: The 14th ESHRE report on ART and IUI treatments shows a continuing expansion of the number of ART treatment cycles in Europe, with more than half a million of cycles reported in 2010. The use of ICSI may have reached a plateau. When compared with 2009/2008, pregnancy and (multiple) delivery rates after IVF and ICSI remained relatively stable. The number of multiple embryo transfers (three or more embryos) has shown a decline.STUDY FUNDING/COMPETING INTERESTS: The study has no external funding; all costs are covered by ESHRE. There are no competing interests.