International Committee for Monitoring Assisted Reproductive Technologies (ICMART) world report: Assisted reproductive technology 2004

Study Questio: NHave changes in assisted reproductive technology (ART) practice and outcomes occurred globally between 2003 and 2004? Summary Answer: Globally, ART practice has changed with an increasing prevalence of the use of ICSI rather than conventional IVF. In 2004, a small but increasing number of countries are incorporating single embryo transfer. There remain unacceptably high rates of three or more embryo transfers in select countries resulting in multiple births and adverse perinatal outcomes. What Is Known Already: World data on the availability, effectiveness and safety of ART have been published since 1989. The number of embryos transferred is a major determinant of the iatrogenic increase in multiple pregnancies and is highly correlated with the likelihood of multiple birth and excess perinatal morbidity and mortality.STUDY Design: , SIZE, DURATIONCross-sectional survey of countries and regions undertaking surveillance of ART procedures started in 2004 and their corresponding outcomes. Participants/Materials, Setting, Methods: Of total, 2184 clinics from 52 reporting countries and regions. Number of ART clinics, types of cycles and procedures, pregnancy, delivery and multiple birth rates and perinatal outcomes. Main Results and the Role of Chance: A total of 954 743 initiated cycles resulted in an estimated 237 809 babies born. This was a 2.3% increase in the number of reported cycles from 2003. The availability of ART varied by country and ranged from 14 to 3844 treatment cycles per million population. Over one-third (37.2%) of ART clinics performed