Figures from the 2015 Assisted Reproductive Technology National - - PowerPoint PPT Presentation

Figures from the 2015 Assisted Reproductive Technology National Summary Report

Locations of ART Clinics in the United States and Puerto Rico, 2015

Number of ART clinics in the United States in 2015 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 499 Number of ART clinics that submitted data in 2015 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 464 Total number of ART cycles started in 2015 at clinics reporting data. . . . . . . . . . . . . . . . . . . . . . . . . . . . 231,936* Number of live-birth deliveries resulting from ART cycles started in 2015 . . . . . . . . . . . . . . . . . . . . . . . . 60,778 Number of infants born as a result of ART cycles started in 2015. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72,913 * Total includes 45,779 cycles with the intent to freeze all eggs or embryos. Live-birth deliveries and infants born are based on remaining 186,157 cycles with intent to transfer at least one egg or embryo. This includes 4,003 cycles with intent to fertilize previously frozen eggs and transfer resulting embryos. This does not include 1 cycle evaluating a new treatment procedure.

Types of ART Cycles—United States,* 2015

Fresh nondonor 39.3% (91,090 cycles) Frozen nondonor embryo 30.1% (69,882 cycles) Egg/embryo banking 19.7% (45,779 cycles) Frozen donor embryo 6.0% (13,846 cycles) Fresh donor 3.2% (7,336 cycles) Frozen egg 1.7% (4,003 cycles) New treatment procedure <0.1% (1 cycle)

* Total does not equal 100% due to rounding.

ART Use by Age Group—United States,* 2015

Age: <35 38.1% Age: 35–37 21.0% Age: 38–40 19.4% Age: 41–42 10.0% Age: 43–44 6.4% Age: >44 5.1%

* Based on 231,936 cycles.

Types of ART Cycles by Age Group—United States,* 2015

(53) (50) (52) (53) (46) (19) (4) (7) (12) (21) (44) (45) (38) (29) (19) (10) (6) (11) (22) (50) 20 40 60 80 100 Percent Age (years) Fresh nondonor Fresh donor Frozen nondonor Frozen donor 95% 90% 82% 65% 29% 97% 4% 5% 10% 18% 34% 71% <35† 35–37 38–40 41–42 43–44† >44

* 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, 2015

26 26 24 23 38 38 40 42 42 46 44 44 34 37 37 41 10 20 30 40 50 60 <102 102–204 205–463 >463 Percent Clinic Size (number of ART cycles performed in 2015) Fresh nondonor Frozen nondonor Fresh donor Frozen donor

Percentages of ART Cycles Using Fresh Embryos from Frozen Nondonor or Donor Eggs That Resulted in Cancellations, Pregnancies, Live Births, and Single-Infant Live Births,* 2015

7.3 29.3 22.7 18.8 6.0 47.2 38.6 30.2 10 20 30 40 50 60 Cancellations Pregnancies Live births Single-infant live births Percent Nondonor Donor

* Cycles using both nondonor and donor frozen eggs are excluded.

Outcomes of ART Cycles Using Fresh Nondonor Eggs or Embryos, by Stage, 2015

91,090 cycles started 80,644 retrievals 59,336 transfers 26,708 pregnancies 21,771 live-birth deliveries 20,000 40,000 60,000 80,000 100,000 Number

Reasons ART Cycles Using Fresh Nondonor Eggs or Embryos Were Canceled, *† 2015

No or not enough egg production 82.3% Patient withdrawal for

• ther reasons

12.5% Over response to

• varian stimulation medication

4.2% Concurrent illness 0.9%

* Based on 10,446 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, 2015

29.3 23.9 18.5 45.0 36.7 28.3 10 20 30 40 50 Pregnancies Live births Single-infant live births Percent Cycles Transfers

Outcomes of ART Cycles Using Fresh Nondonor Eggs or Embryos, 2015

No pregnancy 70.2% Ectopic pregnancy 0.5% Single-fetus pregnancy 20.4% Multiple- fetus pregnancy 6.9% Not able to determine number of fetuses 2.0% Clinical pregnancy 29.3%

Outcomes of Pregnancies That Resulted from ART Cycles Using Fresh Nondonor Eggs or Embryos,*† 2015

Single-infant birth 63.0% Multiple-infant birth 18.6% Stillbirth 0.7% Miscarriage 16.3% Induced abortion 0.9% Unknown 0.7% Total live births 81.6%

* 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, 2015

Single infants 77.2% Twins 22.1% Triplets

• r more

0.6%

• B. 21,771 live births*

Single fetuses 69.6% Twins 22.4% Triplets

• r more

1.0% Not able to determine number of fetuses 7.0%

• A. 26,708 pregnancies

* Total does not equal 100% due to rounding.

Percentages of Preterm Infants or Infants with Low Birth Weight from ART Cycles Using Fresh NondonorEggs or Embryos, by Number of Infants Born, 2015

11.0 16.6 58.2 96.3 9.2 16.0 55.9 93.5 20 40 60 80 100 Single infants from single-fetus pregnancies Single infants from multiple-fetus pregnancies Twins Triplets or more Percent Number of Infants Born Preterm infants Low birth weight infants

Age Distribution of Women Who Had ART Cycles Using Fresh NondonorEggs or Embryos, 2015

1 2 3 4 5 6 7 8 9 10 24 26 28 30 32 34 36 38 40 42 44 46 48 Percent Age (years) <24 >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,* 2015

10 20 30 40 50 60 24 26 28 30 32 34 36 38 40 42 44 Percent Age (years) Pregnancies Live births Single-infant live births <24 >44

* 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,* 2015

20 15 12 8 6 3 14 10 7 3 3 1 11 8 6 3 2 1 10 20 30 40 41 42 43 44 > 44 Percent Age (years) 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, 2015

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

Outcomes of ART Cycles Using Fresh Nondonor Eggs or Embryos, by Stage and Age Group, 2015

93 89 85 80 78 76 71 68 62 54 49 41 38 32 23 14 7 3 33 26 17 8 3 1 20 40 60 80 100 <35 35–37 38–40 41–42 43–44 >44 Percent Age (years) Retrieval Transfer Pregnancy Live birth

Percentages of ART Cycles Using Fresh Nondonor Eggs or Embryos, by Type of Infertility Diagnosis,* 2015

14.3 13.9 30.8 8.8 5.3 34.8 12.8 13.9 11.0 17.7 10 20 30 40 Percent 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, 2015

24.0 28.8 13.1 27.6 17.3 27.1 18.5 29.0 17.3 22.0 10 20 30 40 Percent Diagnosis

Percentages of ART Cycles Using Fresh NondonorEggs or Embryos That Resulted in Live Births, by Age Group and Number of Previous Live Births, 2015

32 25 16 8 3 1 37 28 18 8 4 1 34 29 17 10 3 <1 10 20 30 40 50 <35 35–37 38–40 41–42 43–44 >44 Percent Age (years) 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,* 2015

32.6 25.5 16.2 7.9 2.9 0.9 31.8 24.0 16.5 8.1 3.0 0.9 10 20 30 40 50 <35 35–37 38–40 41–42 43–44 >44 Percent Age (years) 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, 2015

34 28 19 9 3 1 29 23 14 10 3 1 26 21 16 6 3 1 23 15 11 5 2 1 10 20 30 40 50 <35 35–37 38–40 41–42 43–44 >44 Percent Age (years) 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,* 2015

95.0 94.0 93.8 92.5 91.5 94.6 69.3 70.0 71.3 72.7 76.5 80.0 20 40 60 80 100 <35 35–37 38–40 41–42 43–44 >44 Percent Age (years) ICSI, with male factor ICSI, no male factor

* Cycles using GIFT are excluded.

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,* 2015

37 31 22 11 4 1 38 30 21 11 4 <1 34 28 19 10 4 1 10 20 30 40 50 <35 35–37 38–40 41–42 43–44 >44 Percent Age (years) ICSI, with male factor No ICSI, no male factor ICSI, no male factor

* Cycles using GIFT are excluded.

Numbers of Embryos Transferred Among All Transfers Using Fresh Nondonor Eggs or Embryos,* 2015

One 33.5% Two 52.3% Three 10.5% Four 2.5% Five 0.9% Six 0.2% Seven or more 0.1% 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, 2015

41.3 32.1 21.0 10.7 5.2 1.9 10 20 30 40 50 <35 35–37 38–40 41–42 43–44 >44 Percent Age (years)

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, 2015

30.3 22.4 15.3 10.7 10 20 30 40 1 2 3 4+ Percent Number of Embryos Transferred

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,* 2015

(97.9) (65.7) (75.0) (78.2) (2.1) (33.6) (22.0) (19.7) (<0.1) (0.6) (3.0) (2.1) 10 20 30 40 50 1† 2† 3 4+ Percent Number of Embryos Transferred Single infants Twins Triplets or more 36.2% 40.8% 25.0% 17.5%

* 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,* 2015

(97.9) (56.3) (62.4) (100.0) (2.1) (42.7) (28.2) (<0.1) (1.0) (9.4) 10 20 30 40 50 60 70 1† 2 3 4+ Percent Number of Embryos Transferred Single infants Twins Triplets or more 49.5% 56.2% 50.9% 44.4%

* 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.

† Total does not equal 100% due to rounding.

Day of Embryo Transfer* Among Transfers Using Fresh Nondonor Eggs or Embryos,†‡ 2015

Day 1 0.1% Day 2 3.7% Day 3 31.0% Day 4 1.4% Day 5 58.9% Day 6 5.0%

* 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.

‡ Total does not equal 100% due to rounding.

Percentages of Day 3 and Day 5 Embryo Transfers Using Fresh Nondonor Eggs or Embryos That Resulted in Live Births, by Age Group,* 2015

34.9 29.6 21.7 12.0 5.0 0.5 50.3 43.6 32.4 19.6 9.1 3.2 10 20 30 40 50 60 <35 35–37 38–40 41–42 43–44 >44 Percent Age (years) 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 Transfers Using Fresh Nondonor Eggs or Embryos,* 2015

One 20.1% Two 51.2% Three 20.1% Four or more 8.6%

Day 3

One 38.6% Two 54.6% Three 5.8% Four or more 1.1%

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.

† Total does not equal 100% due to rounding.

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,* 2015

Single infants 79.2% Twins 20.0% Triplets

• r more

0.8% Day 3

• A. 4,563 live births

Single infants 76.3% Twins 23.1% Triplets

• r more

0.6% Day 5

• B. 15,120 live births

* 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,* 2015

(97.8) (54.1) (71.0) (2.2) (44.7) (19.4) (<0.1) (1.2) (9.7) 10 20 30 40 50 60 70 1† 2 3+† Percent Number of Embryos Transferred Single infants Twins Triplets or more 50.0% 58.3% 51.7%

* 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.

† 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,* 2015

56.1 46.8 26.9 25.0 18.2 33.3 46.4 38.4 27.5 15.5 6.6 1.7 10 20 30 40 50 60 <35 35–37 38–40 41–42 43–44 >44 Percent Age (years) 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.

Percentages of Embryos Transferred That Implanted Using Frozen Nondonor Embryos, by Age Group, 2015

47.1 43.6 38.3 31.4 23.4 16.2 10 20 30 40 50 <35 35–37 38–40 41–42 43–44 >44 Percent Age (years)

Percentages of Transfers Using Frozen or Fresh Nondonor Embryos That Resulted in Pregnancies, Live Births, and Single-Infant Live Births, 2015

54.6 44.3 36.9 45.0 36.7 28.3 10 20 30 40 50 60 Pregnancies Live births Single-infant live births Percent Frozen nondonor Fresh nondonor

Distribution of Multiple-Fetus Pregnancies and Multiple-Infant Live Births Among ART Cycles Using Frozen Nondonor Embryos, 2015

Single fetuses 75.0% Twins 16.4% Triplets

• r more

0.6% Not able to determine number of fetuses 7.9%

• A. 35,598 pregnancies*

Single infants 83.3% Twins 16.4% Triplets

• r more

0.4%

• B. 28,869 live births*

* Totals do not equal 100% due to rounding.

Percentages of ART Cycles Using Donor Eggs or Embryos, by Age of Woman, 2015

10 20 30 40 50 60 70 80 90 100 24 26 28 30 32 34 36 38 40 42 44 46 48 Percent Age (years) Donor embryo Fresh embryo from fresh donor egg Frozen embryo from donor egg <24 >48

Percentages of Transfers Using Fresh Embryos from Donor or Nondonor Eggs That Resulted in Live Births, by Age of Woman, 2015

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

Distribution of Multiple-Fetus Pregnancies and Multiple-Infant Live Births Among ART Cycles Using Fresh Embryos from Donor Eggs, 2015

Single infants 72.3% Twins 27.3% Triplets

• r more

0.4%

• B. 3,245 live births

Single fetuses 65.4% Twins 27.4% Triplets

• r more

0.9% Not able to determine number of fetuses 6.3%

• A. 3,846 pregnancies

Percentages of Transfers Using Donor Eggs or Embryos That Resulted in Pregnancies, Live Births, and Single-Infant Live Births, 2015

49.5 39.0 30.3 65.9 55.6 40.2 52.7 42.8 35.4 10 20 30 40 50 60 70 80 90 100 Pregnancies Live births Single-infant live births Percent Donor embryo Fresh embryo from fresh donor egg Frozen embryo from donor egg

Numbers of ART Cycles Performed, Live-Birth Deliveries, and Infants Born Using ART, 2006–2015

25,000 50,000 75,000 100,000 125,000 150,000 175,000 200,000 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Number Year ART cycles Live-birth deliveries Infants born

Numbers of ART Cycles Performed for Banking All Fresh Nondonor Eggs or Embryos, 2006–2015

5,000 10,000 15,000 20,000 25,000 30,000 35,000 40,000 45,000 50,000 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Number Year

Numbers of ART Cycles Using Donor Eggs or Embryos, 2006–2015

2,000 4,000 6,000 8,000 10,000 12,000 14,000 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Number Year Donor embryo Fresh embryo from fresh donor egg Frozen embryo from donor egg

Numbers and Percentages of Transfers Using Gestational Carriers, 2006–2015

0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000 4,500 5,000 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Percent Number Year Number Percent

Percentages of Retrievals Using Fresh Nondonor or Donor Eggs or Embryos That Used ICSI,* 2006–2015

10 20 30 40 50 60 70 80 90 100 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Percent Year Overall Male factor No male factor

* Cycles using GIFT are excluded.

Percentages of Transfers Using Fresh Nondonor Eggs or Embryos That Resulted in Single-Infant Live Births, by Age Group, 2006–2015

5 10 15 20 25 30 35 40 2006* 2007* 2008 2009 2010 2011 2012 2013 2014 2015 Percent Year <35 35–37 38–40 41–42 >42 43–44 >44

Age Group:

* 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 NondonorTransfers of One, Two, Three, or Four or More Embryos, 2006–2015

10.7 11.6 11.9 13.5 15.5 16.6 19.5 23.6 28.8 33.5 46.0 48.1 49.8 51.5 52.8 53.9 55.0 55.7 54.2 52.3 27.6 26.0 24.8 23.4 21.3 20.1 17.7 14.6 12.4 10.5 15.8 14.4 13.5 11.6 10.4 9.4 7.8 6.0 4.6 3.7 2006* 2007* 2008 2009 2010 2011 2012 2013* 2014 2015 Percent Year One Two Three Four or more Number of Embryos Transferred

* 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,* 2006–2015

5 10 15 20 25 30 35 40 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Percent Year <35 35–37 38–40 >40

Age Group:

*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, 2006–2015

10 20 30 40 50 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Percent Year One Two Three Four or more Number of Embryos Transferred

Percentages of Live Births Using Fresh Nondonor Eggs or Embryos That Resulted in Multiple Infants Born, by Age Group, 2006–2015

5 10 15 20 25 30 35 40 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Percent Year <35 35–37 38–40 41–42 >42

Age Group:

Percentages of Single Infants, Twins, and Triplets or More Among ART Transfers Using Fresh Nondonor Eggs or Embryos That Resulted in Live Births, 2006–2015

69.3 68.8 68.4 69.5 69.7 71.3 72.6 73.4 75.7 77.2 28.8 29.4 29.8 28.9 28.8 27.5 26.4 25.7 23.3 22.1 1.9 1.8 1.8 1.6 1.5 1.3 1.0 0.9 0.9 0.6 2006 2007 2008 2009 2010 2011* 2012 2013 2014* 2015* Percent Year Single infants Twins Triplets or more

* Totals do not equal 100% due to rounding.