Figures from the 2014 Assisted Reproductive Technology National - - PowerPoint PPT Presentation

Figures from the 2014 Assisted Reproductive Technology National Summary Report

Locations of ART Clinics in the United States and Puerto Rico, 2014

Number of ART clinics in the United States in 2014 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 498 Number of ART clinics that submitted data in 2014 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 458 Total number of ART cycles started in 2014 at clinics reporting data . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208,604* Number of live-birth deliveries resulting from ART cycles started in 2014 . . . . . . . . . . . . . . . . . . . . . . . . 57,323 Number of infants born as a result of ART cycles started in 2014. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70,354 * Total includes 35,406 cycles with the intent to freeze all eggs or embryos. Live-birth deliveries and infants born are based on remaining 173,198 cycles with intent to transfer at least one egg or embryo. This includes 3,596 cycles with intent to fertilize previously frozen eggs and transfer resulting embryos. This does not include 26 cycles evaluating a new treatment procedure.

Types of ART Cycles—United States,* 2014

Fresh nondonor 44.5% (92,862 cycles) Frozen nondonor embryo 27.0% (56,259 cycles) Egg/embryo banking 17.0% (35,406 cycles) Frozen donor embryo 5.7% (11,974 cycles) Fresh donor 4.1% (8,507 cycles) Frozen egg 1.7% (3,596 cycles) New treatment procedure <0.1% (26 cycles)

* Total does not equal 100% due to rounding.

ART Use by Age Group—United States,*† 2014

Age: <35 37.6% Age: 35–37 20.4% Age: 38–40 19.1% Age: 41–42 10.2% Age: 43–44 7.0% Age: >44 5.8%

* Based on 208,604 cycles.

† Total does not equal 100% due to rounding.

Types of ART Cycles by Age Group—United States,* 2014

(58) (56) (57) (57) (48) (22) (5) (8) (15) (24) (38) (39) (33) (24) (17) (9) (5) (10) (20) (44) 96% 4% 95% 5% 90% 10% 81% 18% 65% 35% 31% 68% Percent 20 40 60 80 100 Age (years) <35 35–37 38–40 41–42† 43–44 >44† Fresh nondonor Frozen nondonor Fresh donor Frozen donor

* Percentages of ART cycles that used fresh or frozen embryos from nondonor or donor eggs are in parentheses.

† Totals do not equal 100% due to rounding.

Percentages of ART Cycles That Resulted in Live Births, by Type of ART and Clinic Size—United States, 2014

28 29 28 26 33 37 40 40 46 50 47 49 37 40 39 38 Percent 10 20 30 40 50 60 <97 97–202 203–434 >434 Clinic Size (number of ART cycles performed in 2014) Fresh nondonor Fresh donor Frozen nondonor Frozen donor

Outcomes of ART Cycles Using Fresh Nondonor Eggs or Embryos, by Stage, 2014

92,862 cycles started 83,114 retrievals 67,070 transfers 30,647 pregnancies 25,016 live-birth deliveries Number 20,000 40,000 60,000 80,000 100,000

Reasons ART Cycles Using Fresh Nondonor Eggs or Embryos Were Canceled,*† 2014

No or not enough egg production 82.4% Patient withdrawal for other reasons 11.6% Over response to

• varian stimulation

medication 4.9% Concurrent illness 1.0%

* Based on 9,748 ART cycles.

† Total does not equal 100% due to rounding.

Percentages of ART Cycles and Transfers Using Fresh Nondonor Eggs or Embryos That Resulted in Pregnancies, Live Births, and Single-Infant Live Births, 2014

33.0 26.9 20.4 45.7 37.3 28.3 Percent 10 20 30 40 50 Pregnancies Live births Single-infant live births Cycles Transfers

Outcomes of ART Cycles Using Fresh Nondonor Eggs or Embryos, 2014

No pregnancy 66.4% Ectopic pregnancy 0.6% Single-fetus pregnancy 22.5% Multiple- fetus pregnancy 8.3% Not able to determine number

• f fetuses 2.2%

Clinical pregnancy 33.0%

Outcomes of Pregnancies That Resulted from ART Cycles Using Fresh Nondonor Eggs or Embryos,*† 2014

Single-infant birth 61.8% Multiple-infant birth 19.8% Total live births 81.6% Stillbirth 0.6% Miscarriage 16.2% Induced abortion 0.9% Unknown 0.6%

* Maternal deaths prior to birth are not displayed due to small number of cycles.

† Total does not equal 100% due to rounding.

Distribution of Multiple-Fetus Pregnancies and Multiple-Infant Live Births Among ART Cycles Using Fresh Nondonor Eggs or Embryos, 2014

• A. 30,647 pregnancies

Single fetuses 68.1% Twins 23.7% Triplets or more 1.5% Not able to determine number of fetuses 6.7%

• B. 25,016 live births*

Single infants 75.7% Twins 23.3% Triplets or more 0.9%

* Total does not equal 100% due to rounding.

Percentages of Preterm Infants or Infants with Low Birth Weight from ART Cycles Using Fresh Nondonor Eggs or Embryos, by Number of Infants Born, 2014

10.9 16.8 56.8 98.7 9.0 14.9 55.4 93.7 Percent 20 40 60 80 100 Single infants from single-fetus pregnancies Single infants from multiple-fetus pregnancies Twins Triplets or more Number of Infants Born Preterm infants Low birth weight infants

Age Distribution of Women Who Had ART Cycles Using Fresh Nondonor Eggs or Embryos, 2014

Percent 1 2 3 4 5 6 7 8 9 10 Age (years) <24 24 26 28 30 32 34 36 38 40 42 44 46 48 >48 Mean Median

Percentages of ART Cycles Using Fresh Nondonor Eggs or Embryos That Resulted in Pregnancies, Live Births, and Single-Infant Live Births, by Age of Woman,* 2014

Percent 10 20 30 40 50 Age (years) <24 24 26 28 30 32 34 36 38 40 42 44 >44 Pregnancies Live births Single-infant live births

* For consistency, all percentages are based on cycles started.

Percentages of ART Cycles Using Fresh Nondonor Eggs or Embryos That Resulted in Pregnancies, Live Births, and Single-Infant Live Births Among Women Aged 40 or Older,* 2014

23 18 15 10 6 3 16 11 8 5 2 1 13 9 7 4 2 1 Percent 10 20 30 Age (years) 40 41 42 43 44 >44 Pregnancies Live births Single-infant live births

* For consistency, all percentages are based on cycles started.

Percentages of ART Cycles Using Fresh Nondonor Eggs or Embryos That Resulted in Miscarriage, by Age of Woman, 2014

Percent 10 20 30 40 50 60 70 Age (years) <24 24 26 28 30 32 34 36 38 40 42 44 >44

Outcomes of ART Cycles Using Fresh Nondonor Eggs or Embryos, by Stage and Age Group, 2014

94 90 87 83 81 75 78 76 70 62 55 40 43 36 27 16 9 3 37 30 19 10 4 1 Percent 20 40 60 80 100 Age (years) <35 35–37 38–40 41–42 43–44 >44 Retrieval Transfer Pregnancy Live birth

Percentages of ART Cycles Using Fresh Nondonor Eggs or Embryos, by Type of Infertility Diagnosis,* 2014

14.2 13.7 30.8 9.3 5.5 35.1 12.4 14.1 11.2 17.9 Percent 10 20 30 40 Diagnosis

* Total percentages are greater than 100% because more than one diagnosis can be reported for each cycle.

Percentages of ART Cycles Using Fresh Nondonor Eggs or Embryos That Resulted in Live Births, by Type of Infertility Diagnosis, 2014

27.1 32.9 14.6 29.0 20.6 30.5 21.8 32.3 18.7 24.9 Percent 10 20 30 40 Diagnosis

Percentages of ART Cycles Using Fresh Nondonor Eggs or Embryos That Resulted in Live Births, by Age Group and Number of Previous Live Births, 2014

36 29 18 9 3 1 40 32 22 11 4 2 39 33 23 9 5 1 Percent 10 20 30 40 50 Age (years) <35 35–37 38–40 41–42 43–44 >44 No previous live births 1 previous live birth 2 or more previous live births

Percentages of ART Cycles Using Fresh Nondonor Eggs or Embryos That Resulted in Live Births, by Age Group and History of Miscarriage, Among Women with No Previous Births,* 2014

36.9 29.1 18.8 9.2 3.1 1.1 34.7 28.3 17.6 9.5 3.5 1.0 Percent 10 20 30 40 50 Age (years) <35 35–37 38–40 41–42 43–44 >44 No previous pregnancies 1 or more previous miscarriages

* Women reporting only previous ectopic pregnancies or pregnancies that ended in induced abortion are not included.

Percentages of ART Cycles Using Fresh Nondonor Eggs or Embryos That Resulted in Live Births, by Age Group and Number of Previous ART Cycles, Among Women with No Previous Live Births, 2014

39 32 20 10 3 2 31 26 17 10 5 30 26 16 8 2 1 26 22 14 7 3 1 Percent 10 20 30 40 50 Age (years) <35 35–37 38–40 41–42 43–44 >44 No previous cycles 1 previous cycle 2 previous cycles 3 or more previous cycles

Percentages of Retrievals Using Fresh Nondonor Eggs or Embryos That Used ICSI, 2014

94.9 93.5 93.2 92.5 90.2 88.8 66.8 67.5 69.0 70.9 73.9 77.6 Percent 20 40 60 80 100 Age (years) <35 35–37 38–40 41–42 43–44 >44 ICSI, with male factor ICSI, no male factor

Percentages of Fresh Nondonor Retrievals That Resulted in Live Births Among Patients with or Without Diagnosed Male Factor Infertility, by Age Group and Use of ICSI,* 2014

41 34 24 14 6 1 41 36 24 11 5 1 38 32 21 12 4 1 Percent 10 20 30 40 50 Age (years) <35 35–37 38–40 41–42 43–44 >44 ICSI, with male factor No ICSI, no male factor ICSI, no male factor

* Cycles using donor sperm and cycles using GIFT or ZIFT are excluded.

Numbers of Embryos Transferred Among All Transfers Using Fresh Nondonor Eggs or Embryos,* 2014

One 28.8% Two 54.1% Three 12.4% Four 3.2% Five 1.1% Six 0.2% Seven or more 0.1% Zero or unknown <0.1%

* Total does not equal 100% due to rounding.

Percentages of Embryos Transferred That Implanted Using Fresh Nondonor Eggs or Embryos, by Age Group, 2014

41.1 32.3 21.1 10.8 5.0 2.3 Percent 10 20 30 40 50 Age (years) <35 35–37 38–40 41–42 43–44 >44

Percentages of Transfers Using Fresh Nondonor Eggs or Embryos That Resulted in Live Births of Single, Term, and Normal Birth Weight Infants, by Number of Embryos Transferred, 2014

30.5 23.1 16.0 11.7 Percent 10 20 30 40 Number of Embryos Transferred 1 2 3 4+

Percentages of Transfers Using Fresh Nondonor Eggs or Embryos That Resulted in Live Births and Distribution of Number of Infants Born, by Number of Embryos Transferred,* 2014

(98.4) (65.6) (73.8) (77.6) (1.6) (33.4) (22.6) (20.8) (<0.1) (0.9) (3.6) (1.6) 36.1% 42.1% 26.2% 18.2% Percent 10 20 30 40 50 Number of Embryos Transferred 1† 2† 3 4+ Single infants Twins Triplets or more

* Percentages of transfers resulting in live births are shown on top of each bar graph. Percentages of live births that were single infants, twins, and triplets or more are in parentheses.

† Totals do not equal 100% due to rounding.

Percentages of Transfers Using Fresh Nondonor Eggs or Embryos That Resulted in Live Births and Distribution of Number of Infants Born Among Good-Prognosis Women, by Number of Embryos Transferred,* 2014

(98.3) (57.1) (58.2) (42.9) (1.7) (41.6) (35.5) (57.1) (<0.1) (1.3) (6.4) 52.2% 56.6% 39.7% 36.8% Percent 10 20 30 40 50 60 70 Number of Embryos Transferred 1† 2 3† 4+ Single infants Twins Triplets or more

* Percentages of transfers resulting in live births are shown on top of each bar graph. Percentages of live births that were single infants, twins, and triplets or more are in parentheses.

† Totals do not equal 100% due to rounding.

Day of Embryo Transfer* Among All ART Transfers Using Fresh Nondonor Eggs or Embryos,† 2014

Day 1 0.1% Day 2 3.6% Day 3 35.8% Day 4 1.5% Day 5 54.3% Day 6 4.7%

* Number of days following egg retrieval.

† Cycles using GIFT or ZIFT are excluded. Missing or implausible values for day of embryo transfer

(that is, 0 or greater than 6) are not included.

Percentages of Day 3 and Day 5 Embryo Transfers Using Fresh Nondonor Eggs or Embryos That Resulted in Live Births, by Age Group,* 2014

36.1 31.4 22.5 12.6 5.5 1.7 52.6 45.5 34.1 20.2 9.3 6.2 Percent 10 20 30 40 50 60 Age (years) <35 35–37 38–40 41–42 43–44 >44 Day 3 Day 5

* Cycles using GIFT or ZIFT are excluded. Embryo transfers performed on days 1, 2, 4, and 6 are not included because each of these accounted for a small proportion of procedures.

Numbers of Embryos Transferred on Day 3 and Day 5 Among All Transfers Using Fresh Nondonor Eggs or Embryos,* 2014

Day 3

One 18.5% Two 50.5% Three 21.4% Four or more 9.6%

Day 5

One 33.6% Two 58.3% Three 6.9% Four or more 1.2%

* Cycles using GIFT or ZIFT are excluded. Embryo transfers performed on days 1, 2, 4, and 6 are not included because each of these accounted for a small proportion of procedures.

Distribution of Number of Infants Born Among Day 3 and Day 5 Embryo Transfers Using Fresh Nondonor Eggs or Embryos That Resulted in Live Births,* 2014

Day 3

• A. 6,242 live births

Single infants 77.8% Twins 21.1% Triplets

• r more

1.1% Day 5

• B. 16,531 live births

Single infants 74.4% Twins 24.7% Triplets

• r more

0.9%

* Cycles using GIFT or ZIFT are excluded. Embryo transfers performed on days 1, 2, 4, and 6 are not included because each of these accounted for a small proportion of procedures.

Percentages of Day 5 Transfers Using Fresh Nondonor Eggs or Embryos That Resulted in Live Births and Distribution of Number of Infants Born Among Good-Prognosis Women, by Number of Embryos Transferred,* 2014

(98.3) (54.6) (58.9) (1.6) (43.9) (35.7) (<0.1) (1.4) (5.4) 53.3% 59.0% 49.1% Percent 10 20 30 40 50 60 70 Number of Embryos Transferred 1† 2† 3+ Single infants Twins Triplets or more

* Percentages of transfers resulting in live births are shown on top for each bar graph. Percentages of live births that were single infants, twins, and triplets or more are in parentheses. Cycles using GIFT or ZIFT are excluded.

† Totals do not equal 100% due to rounding.

Percentages of Transfers Using Fresh Nondonor Eggs or Embryos That Resulted in Live Births Among ART Cycles That Used Gestational Carriers and Those That Did Not, by Age Group,* 2014

54.7 46.5 32.3 26.4 7.1 47.5 39.6 28.0 15.6 7.0 3.0 Percent 10 20 30 40 50 60 Age (years) <35 35–37 38–40 41–42 43–44† >44 Used a gestational carrier Did not use a gestational carrier

* Age groups reflect the age of the ART patient, not the age of the gestational carrier.

† There were no transfers resulting in live births among patients aged 43–44 who used gestational carriers.

Percentages of Embryos Transferred That Implanted Using Frozen Nondonor Embryos, by Age Group, 2014

43.7 40.8 35.2 28.4 19.9 12.9 Percent 10 20 30 40 50 Age (years) <35 35–37 38–40 41–42 43–44 >44

Percentages of Transfers Using Frozen or Fresh Nondonor Embryos That Resulted in Pregnancies, Live Births, and Single-Infant Live Births, 2014

52.8 42.4 34.4 45.7 37.3 28.3 Percent 10 20 30 40 50 60 Pregnancies Live births Single-infant live births Frozen nondonor Fresh nondonor

Distribution of Multiple-Fetus Pregnancies and Multiple-Infant Live Births Among ART Cycles Using Frozen Nondonor Embryos, 2014

• A. 27,757 pregnancies

Single fetuses 72.2% Twins 18.5% Triplets

• r more

0.9% Not able to determine number of fetuses 8.4%

• B. 22,267 live births

Single infants 81.1% Twins 18.4% Triplets

• r more

0.5%

Percentages of ART Cycles Using Donor Eggs, by Age of Woman, 2014

Percent 10 20 30 40 50 60 70 80 90 100 Age (years) <24 24 26 28 30 32 34 36 38 40 42 44 46 48 >48

Percentages of Transfers Using Fresh Embryos from Donor or Nondonor Eggs That Resulted in Live Births, by Age of Woman, 2014

Percent 10 20 30 40 50 60 70 80 90 100 Age (years) <30 30 32 34 36 38 40 42 44 46 >47 Donor eggs Nondonor eggs

Distribution of Multiple-Fetus Pregnancies and Multiple-Infant Live Births Among ART Cycles Using Fresh Embryos from Donor Eggs, 2014

• A. 4,849 pregnancies*

Single fetuses 63.3% Twins 30.3% Triplets

• r more

0.8% Not able to determine number of fetuses 5.5%

• B. 4,125 live births*

Single infants 69.6% Twins 30.1% Triplets

• r more

0.4%

* Totals do not equal 100% due to rounding.

Percentages of Transfers Using Frozen or Fresh Donor Embryos That Resulted in Pregnancies, Live Births, and Single-Infant Live Births, 2014

51.7 41.5 32.9 66.8 56.9 39.5 Percent 10 20 30 40 50 60 70 Pregnancies Live births Single-infant live births Frozen donor Fresh donor

Numbers of ART Cycles Performed, Live-Birth Deliveries, and Infants Born Using ART, 2005–2014

Number 20,000 40,000 60,000 80,000 100,000 120,000 140,000 160,000 180,000 Year 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Art cycles Live-birth deliveries Infants born

Numbers of ART Cycles Performed for Banking All Fresh Nondonor Eggs or Embryos, 2005–2014

Number 5,000 10,000 15,000 20,000 25,000 30,000 35,000 40,000 Year 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Numbers of ART Cycles Using Donor Eggs or Embryo, 2005–2014

Number 2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000 18,000 20,000 22,000 Year 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Numbers and Percentages of Transfers Using Gestational Carriers, 2005–2014

Number 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000 4,500 Percent 0.5 1.0 1.5 2.0 2.5 3.0 Year 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Number Percent

Percentages of Retrievals Using Fresh Nondonor or Donor Eggs or Embryos That Used ICSI, 2005–2014

Percent 10 20 30 40 50 60 70 80 90 100 Year 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Overall Male factor No male factor

Percentages of Transfers Using Fresh Nondonor Eggs or Embryos That Resulted in Single-Infant Live Births, by Age Group, 2005–2014

Percent 10 20 30 40 Year 2005 2006* 2007* 2008 2009 2010 2011 2012 2013 2014

Age Group:

<35 35–37 38–40 41–42 >42 43–44 >44

* Through 2006, data for women older than age 42 were combined. Starting in 2007, data for women older than age 42 were reported as women aged 43–44 and women older than age 44.

Percentages of Fresh Nondonor Transfers of One, Two, Three, or Four or More Embryos, 2005–2014

9.3 10.7 11.6 11.9 13.5 15.5 16.6 19.5 23.6 28.8 43.4 46.0 48.1 49.8 51.5 52.8 53.9 55.0 55.7 54.2 29.5 27.6 26.0 24.8 23.4 21.3 20.1 17.7 14.6 12.4 17.9 15.8 14.4 13.5 11.6 10.4 9.4 7.8 6.0 4.6 Percent Year 2005* 2006* 2007* 2008 2009 2010 2011 2012 2013* 2014 Number of Embryos Transferred One Two Three Four or more

* Totals do not equal 100% due to rounding.

Percentages of Elective Single Embryo Transfer (eSET) Among All Transfers Using Fresh Nondonor Eggs or Embryos, by Age Group,* 2005–2014

Percent 5 10 15 20 25 30 Year 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Age Group:

<35 35–37 38–40 >40

* All ages older than 40 years are reported together due to the small number of transfers performed with eSET.

Percentages of Transfers Using Fresh Nondonor Eggs or Embryos That Resulted in Live Births, by Number of Embryos Transferred, 2005–2014

Percent 10 20 30 40 50 Year 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Number of Embryos Transferred One Two Three Four or more

Percentages of Live Births Using Fresh Nondonor Eggs or Embryos That Resulted in Multiple Infants Born, by Age Group, 2005–2014

Percent 10 20 30 40 50 Year 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Age Group:

<35 35–37 38–40 41–42 >42

Percentages of Single Infants, Twins, and Triplets or More Among ART Transfers Using Fresh Nondonor Eggs or Embryos That Resulted in Live Births, 2005–2014

68.0 69.3 68.8 68.4 69.5 69.7 71.3 72.6 73.4 75.7 29.6 28.8 29.4 29.8 28.9 28.8 27.5 26.4 25.7 23.3 2.4 1.9 1.8 1.8 1.6 1.5 1.3 1.0 0.9 0.9 Percent Year 2005 2006 2007 2008 2009 2010 2011* 2012 2013 2014* Single infants Twins Triplets or more

* Totals do not equal 100% due to rounding.