O-151 ICMART preliminary world report 2018

Abstract

Abstract Abstract title International Committee for Monitoring Assisted Reproductive Technologies (ICMART) Preliminary World Report on ART, 2018 Study question In 2018 what was global utilization, effectiveness and safety of ART? Summary answer Globally, ART utilization and data collection continue to increase but with wide variations in utilization, effectiveness and safety. What is known already ICMART began ART global data collection in 1991. Utilization, effectiveness and safety have continuously improved with more cycles, higher pregnancy rates and lower multiple birth rates, the latter as a result of transfer of fewer embryos. Frozen embryo transfer (FET) and donor egg cycles continue to increase. However, wide variations in practice and outcomes exist globally. Approximately 9 million ART babies have been born. ICMART has helped develop registries internationally. A new electronic data collection platform has been developed in conjunction with the University of New South Wales in Sydney, Australia; nevertheless, data collection and quality remain challenging. Study design, size, duration Countries and regions annually collect ART data, some prospectively and others retrospectively. ICMART retrospectively requested these data from all known global sources for 2018 and reviewed them for missing or incorrect data. The dataset was corrected and then analyzed utilizing standardized definitions from The ICMART/WHO Revised Glossary on ART Terminology, 2009 which was current at the time but is now replaced by The International Glossary on Infertility and Fertility Care, 2017, and previously developed methods. Preliminary results are presented. Participants/materials, setting, methods The European IVF Monitoring Consortium (EIM), Latin American Network of Assisted Reproduction (REDLARA), Australian/ New Zealand Registry and African Network and Registry for ART (ANARA) submitted regional data, and other countries contributed national data, through standardized formats to ICMART. A few individual clinics with no registry access also contributed. Data were reviewed, corrected, validated to the extent possible, analyzed and summarized by ICMART using descriptive statistics. Main results and the role of chance Data collection and analysis are ongoing, so presented results are preliminary. The number of ART cycles continues to increase, but utilization is still highly variable among countries and regions. Regional and country differences persist in the age of women treated, number of embryos transferred, live birth rates, rate of multiple births, use of ICSI, cryopreservation cycles and other factors. The role of chance is minimal. Actual global ART results are limited to reporting countries and clinics representing approximately 3/4 of global cycles. However, this is a very large sample size from which imputation of total global results is performed. Limitations, reasons for caution Some countries have limited data and many countries have limited data validation. ICMART can perform only minimal verification of submitted data. Widespread adherence to consensus definitions provided in the Glossary takes time and requires translation into multiple languages. Wider implications of the findings ICMART World Reports standardize data, track trends, enable comparisons, stimulate questions and improve ART quality. Better understanding of ART increases societal acceptance and support for equitable access and ART research.