A comparison of assisted reproductive technologies and outcomes between Europe and the United States

Abstract

ObjectiveThe practice of assisted reproductive technologies (ART) differs between the United States and European countries in many ways including treatment guidelines, restrictions and outcomes. A formal evaluation of the differences in ART has just recently become possible with the reporting of annual outcomes through the Center for Disease Control (CDC) in the United States and the European Society for Human Reproduction and Embryology (ESHRE).DesignRetrospective data analysis.Materials and methodsPublished data from the CDC and ESHRE for the year 2002 was extracted and entered into a database. Values not reported were calculated when possible. European countries were divided into location by region: Eastern Europe, Mediterranean, Scandinavia and Western Europe.ResultsTotal clinics/reporting are 428/391 in the US and 631/770 in Europe. Total pregnancies per cycle and deliveries per cycle are slightly higher for USA clinics (pregnancies: 34.3% vs. 21.6%, P=0.5 and deliveries: Table 2). The USA clinics had a higher number of embryos transferred (Table 1) and higher multiple deliveries (Table 2) than the European clinics as a whole, but this difference was not statistically significant and was less defined when dividing the countries by region.Table 1Percentage of cycles by the number of embryos transferred for USA and EuropeNumber of Embryos1234+USA6.7a31.6b33.6c28.1dEastern Europe14.737.334.413.6Mediterranean13.736.226.623.5Scandinavia29.367.73.00.0Western Europe11.652.730.94.7All of Europe13.7a54.8b26.9c4.7dP values: a0.44, b0.13, c0.35, d0.54. Open table in a new tab Table 2Live births for USA and EuropeLive BirthAll (% cycles)All (% pregnancies)SingletonTwinTripletUSA28.3a82.7b64.6c31.6d3.8eEastern Europe17.270.871.825.92.3Mediterranean16.877.773.623.72.6Scandinavia17.278.178.221.60.3Western Europe13.771.274.623.61.9All of Europe16.2a74.5b74.6c23.7d1.8eP value: a0.47, b0.13, c0.12, d0.63, e0.74. Open table in a new tab ConclusionsThe data presented in this analysis contradicts the commonly held belief that the numbers of embryos transferred and the rates of multiple pregnancy are lower in European countries than in the United States. It is beneficial to view the data by country and region in order to get an understanding of the differing practice patterns of the world ART programs. ObjectiveThe practice of assisted reproductive technologies (ART) differs between the United States and European countries in many ways including treatment guidelines, restrictions and outcomes. A formal evaluation of the differences in ART has just recently become possible with the reporting of annual outcomes through the Center for Disease Control (CDC) in the United States and the European Society for Human Reproduction and Embryology (ESHRE). The practice of assisted reproductive technologies (ART) differs between the United States and European countries in many ways including treatment guidelines, restrictions and outcomes. A formal evaluation of the differences in ART has just recently become possible with the reporting of annual outcomes through the Center for Disease Control (CDC) in the United States and the European Society for Human Reproduction and Embryology (ESHRE). DesignRetrospective data analysis. Retrospective data analysis. Materials and methodsPublished data from the CDC and ESHRE for the year 2002 was extracted and entered into a database. Values not reported were calculated when possible. European countries were divided into location by region: Eastern Europe, Mediterranean, Scandinavia and Western Europe. Published data from the CDC and ESHRE for the year 2002 was extracted and entered into a database. Values not reported were calculated when possible. European countries were divided into location by region: Eastern Europe, Mediterranean, Scandinavia and Western Europe. ResultsTotal clinics/reporting are 428/391 in the US and 631/770 in Europe. Total pregnancies per cycle and deliveries per cycle are slightly higher for USA clinics (pregnancies: 34.3% vs. 21.6%, P=0.5 and deliveries: Table 2). The USA clinics had a higher number of embryos transferred (Table 1) and higher multiple deliveries (Table 2) than the European clinics as a whole, but this difference was not statistically significant and was less defined when dividing the countries by region.Table 1Percentage of cycles by the number of embryos transferred for USA and EuropeNumber of Embryos1234+USA6.7a31.6b33.6c28.1dEastern Europe14.737.334.413.6Mediterranean13.736.226.623.5Scandinavia29.367.73.00.0Western Europe11.652.730.94.7All of Europe13.7a54.8b26.9c4.7dP values: a0.44, b0.13, c0.35, d0.54. Open table in a new tab Table 2Live births for USA and EuropeLive BirthAll (% cycles)All (% pregnancies)SingletonTwinTripletUSA28.3a82.7b64.6c31.6d3.8eEastern Europe17.270.871.825.92.3Mediterranean16.877.773.623.72.6Scandinavia17.278.178.221.60.3Western Europe13.771.274.623.61.9All of Europe16.2a74.5b74.6c23.7d1.8eP value: a0.47, b0.13, c0.12, d0.63, e0.74. Open table in a new tab Total clinics/reporting are 428/391 in the US and 631/770 in Europe. Total pregnancies per cycle and deliveries per cycle are slightly higher for USA clinics (pregnancies: 34.3% vs. 21.6%, P=0.5 and deliveries: Table 2). The USA clinics had a higher number of embryos transferred (Table 1) and higher multiple deliveries (Table 2) than the European clinics as a whole, but this difference was not statistically significant and was less defined when dividing the countries by region. P values: a0.44, b0.13, c0.35, d0.54. P value: a0.47, b0.13, c0.12, d0.63, e0.74. ConclusionsThe data presented in this analysis contradicts the commonly held belief that the numbers of embryos transferred and the rates of multiple pregnancy are lower in European countries than in the United States. It is beneficial to view the data by country and region in order to get an understanding of the differing practice patterns of the world ART programs. The data presented in this analysis contradicts the commonly held belief that the numbers of embryos transferred and the rates of multiple pregnancy are lower in European countries than in the United States. It is beneficial to view the data by country and region in order to get an understanding of the differing practice patterns of the world ART programs.