USA and International Trends in ART Access and Outcomes
ASRM28 October 2009
Atlanta, GA - Data released today at the American Society for Reproductive Medicine Annual Meeting in Atlanta compares ART trends in the US with those around the world. Using data collected through the International Committee Monitoring ART (ICMART), investigators examined data from 2000- 2004. They found that delivery rates in the US were stable at 31% while they improved in Europe from 16% to 22%.
The delivery rate was maintained in the US even as the number of embryos transferred declined from 3.0 to 2.7 embryos per transfer, and the US triplet rate was cut in half from 4.3% to 2.6%. Only Sweden saw a marked reduction in its twin rate over the period, going from 21.8% to only 5.6%.
The same investigators used 2004 data to examine how economic factors influence the risk and benefit calculations of patients and physicians. They found that in countries where government provides free access to ART treatment, the utilization rate for those treatments is much higher. For example, in France there were 2,008 cycles for every million inhabitants, while in the US there were only 357 cycles per million people. Improved access not only raises the utilization rate, but changes outcomes, as well. The number of embryos transferred per cycle and the resulting high order multiple births are highest in those countries that do not provide free access.
This relationship was seen within countries, as well. In the USA, individual states with mandatory insurance coverage for IVF treatments saw different results than states without such a mandate. Researchers at the Yale University School of Medicine found that the number of embryos transferred per cycle, cancellation rate, twin rate and multiple live birth rate were all higher in mandated states than in non-mandated ones.
“These studies make it clear that policies that promote access to infertility treatment also promote making those treatments safer and more effective,” stated Elizabeth Ginsburg, MD, President of the Society for Assisted Reproductive Technology (SART).