Ishihara Osamu, Adamson G David, Dyer Silke, de Mouzon Jacques, Nygren Karl G, Sullivan Elizabeth A, Zegers-Hochschild Fernando, Mansour Ragaa
Department of Obstetrics and Gynaecology, Saitama Medical University, Moroyama, Japan.
Palo Alto Medical Foundation Fertility Physicians of North California, San Jose, California.
Fertil Steril. 2015 Feb;103(2):402-13.e11. doi: 10.1016/j.fertnstert.2014.11.004. Epub 2014 Dec 13.
To analyze information on assisted reproductive technology (ART) performed worldwide, and trends in outcomes over successive years.
Cross-sectional survey on access, efficiency, and safety of ART procedures performed in 55 countries during 2007.
Not applicable.
PATIENT(S): Infertile women and men undergoing ART globally.
INTERVENTION(S): Collection and analysis of international ART data.
MAIN OUTCOME MEASURE(S): Number of cycles performed, by country and region, including pregnancies, single and multiple birth rates, and perinatal mortality.
RESULT(S): Overall, >1,251,881 procedures with ART were reported, and resulted in 229,442 reported babies born. The availability of ART varied by country, from 12 to 4,140 treatments per million population. Of all aspiration cycles, 65.2% (400,617 of 614,540) were intracytoplasmic sperm injection. The overall delivery rate per fresh aspiration was 20.3%, and for frozen-embryo transfer (FET), 18.4%, with a cumulative delivery rate of 25.8%. With wide regional variations, single-embryo transfer represented 23.4% of fresh transfers, and the proportion of deliveries with twins and triplets from fresh transfers was 22.3% and 1.2%, respectively. The perinatal mortality rate was 19.9 per 1,000 births for fresh in vitro fertilization using intracytoplasmic sperm injection, and 9.6 per 1,000 for FET. The proportion of women aged ≥40 years increased to 19.8% from 15.5% in 2006.
CONCLUSION(S): The international trend toward <3 transferred embryos continued, as did the wider uptake of FET. This was achieved without compromising delivery rates. The application of ART for women aged >40 years was a major component of ART services in some regions and countries.
分析全球辅助生殖技术（ART）实施情况及连续数年的结局趋势。
2007年对55个国家ART程序的可及性、效率和安全性进行的横断面调查。
不适用。
全球接受ART的不孕女性和男性。
收集和分析国际ART数据。
按国家和地区划分的ART周期数，包括妊娠数、单胎和多胎出生率以及围产期死亡率。
总体而言，报告了超过1,251,881例ART程序，并有229,442例婴儿出生。ART的可及性因国家而异，每百万人口中从12例到4,140例治疗不等。在所有抽吸周期中，65.2%（614,540例中的400,617例）为卵胞浆内单精子注射。新鲜抽吸的总体分娩率为20.3%，冷冻胚胎移植（FET）为18.4%，累积分娩率为25.8%。存在广泛的地区差异，单胚胎移植占新鲜移植的23.4%，新鲜移植的双胎和三胎分娩比例分别为22.3%和1.2%。卵胞浆内单精子注射新鲜体外受精的围产期死亡率为每1000例出生19.9例，FET为每1000例出生9.6例。年龄≥40岁的女性比例从2006年的15.5%增至19.8%。
国际上向移植胚胎数＜3个的趋势持续，FET的应用也更为广泛。这在不影响分娩率的情况下得以实现。对40岁以上女性应用ART是一些地区和国家ART服务的主要组成部分。
