Abstract

BACKGROUND

European results of assisted reproductive techniques from treatments initiated during 2004 are presented in this eighth report.

METHODS

Data were mainly collected from existing national registers. From 29 countries, 785 clinics reported 367 066 treatment cycles including: IVF (114 672), ICSI (167 192), frozen embryo replacement (FER, 71 997), egg donation (ED, 10 334), preimplantation genetic diagnosis/screening (PGD/PGS, 2701) and in vitro maturation (IVM, 170). Overall, this represents only a marginal increase since 2003, due to a huge reduction in treatments in Germany. European data on intrauterine insemination using husband/partner’s semen (IUI-H) and donor semen (IUI-D) were reported from 20 countries. A total of 115 980 cycles (IUI-H, 98 388; IUI-D, 17 592) were included.

RESULTS

In 14 countries where all clinics reported to the IVF register, a total of 248 937 ART cycles were performed in a population of 261.6 million, corresponding to 1095 cycles per million inhabitants. For IVF, the clinical pregnancy rates per aspiration and per transfer were 26.6% and 30.1%, respectively. For ICSI, the corresponding rates were 27.1% and 29.8%. After IUI-H, the clinical pregnancy rate was 12.6% in women below 40. After IVF and ICSI, the distribution of transfer of 1, 2, 3 and 4 or more embryos was 19.2%, 55.3%, 22.1% and 3.3%, respectively. Compared with 2003, fewer embryos were transferred, but huge differences still existed between countries. The distribution of singleton, twin and triplet deliveries after IVF and ICSI combined was 77.2%, 21.7% and 1.0%, respectively. This gives a total multiple delivery rate of 22.7% compared with 23.1% in 2003 and 24.5% in 2002. After IUI-H in women below 40 years of age, 11.9% were twin and 1.3% triplet gestations.

CONCLUSIONS

Compared with earlier years, the reported number of ART cycles in Europe increased and the pregnancy rates increased marginally, even though fewer embryos were transferred and the multiple delivery rates were reduced.

Introduction

This report is the eighth annual European Society of Human Reproduction and Embryology (ESHRE) publication on European data on assisted reproduction technology (ART). The seven previous reports, also published in Human Reproduction (ESHRE, 2001a,b, 2002, 2004, 2005, 2006, 2007), covered treatment cycles from 1997 to 2003.

Data have been collected from 29 European countries on ART covering IVF, ICSI, frozen embryo replacement (FERs), egg donation (EDs), in vitro maturation (IVM) and pooled data on preimplantation genetic diagnosis (PGD) and screening (PGS) during 2004. Data on intrauterine inseminations using husband/partner’s semen (IUI-H; 19 countries) and donor semen (IUI-D; 15 countries) were also included. According to the International Committee for Monitoring ART-World Health Organization (ICMART-WHO) definitions (World Health Organization, 2002; Zegers-Hochschild 2006a,b) IUI-H and IUI-D should not be classified as ART. However, the European IVF Monitoring (EIM) Consortium has decided to continue to include the IUI activity in the annual reports. The reasons for this are that IUI is common, contributes to fertility-related births and predisposes to risks such as multiple pregnancy. They also involve the use of donor gametes. Finally, accreditation of all clinics according to the new European Union Tissue and Cell Directive includes all clinics that perform IUI (Directive, 2004).

The annual meeting with the EIM Consortium was held at the ESHRE meeting in Lyon in July 2007 with representatives from the participating countries. The present and future reporting systems were discussed. The Czech Republic and Croatia were unable to provide data for 2004, but Albania and Turkey joined the consortium and provided data. The Turkish data available are collected by the organization of private IVF centres and covered 4 out of 78 clinics. However, the Turkish Ministry of Health also has a register, and this may for the coming years contribute to the EIM programme. The consortium stressed that efforts should be made to have better coverage in the Balkan and Eastern European countries. To that end an ESHRE–EIM workshop was held in Sofia during September 2007.

The consortium noted that the quality of data continues to vary between countries. In some large southern European countries, there was scope for improvement in terms of the proportion of clinics providing data: Spain (84/182, 46%), Greece (16/49, 33%) and Italy (133/218, 61%). In Italy, a mandatory national data collection programme is now established, and both Spain and Greece will follow soon.

In 2004, data collection systems, coverage, definitions and validation still differed between countries. However, since the ESHRE Consortium meeting in Madrid 2003, it was decided that in the coming years the EIM Consortium members should continue to adapt to the definitions listed by the ICMART as originally published in the WHO report (World Health Organization, 2002), and now in Human Reproduction (Zegers-Hochschild et al., 2006a) and Fertility and Sterility (Zegers-Hochschild et al., 2006b).

The Consortium decided to continue to present annual reports and to try to improve the quality of the reports.

Materials and Methods

Data collection

The present report summarizes data from ART treatments, including IVF, ICSI, ED, FER, PGD/PGS, IVM and IUI-H and IUI-D started between the 1st of January 2004 and the 31st of December 2004. Follow-up data on pregnancies and deliveries are cohort data. For IUI only pregnancies, and not deliveries, were recorded. The number of clinics reporting IUI data may differ from the number of clinics presenting data on the in vitro techniques.

As it is evident from the tables, registers from a number of countries have been unable to provide some of the data.

The reporting principle used for 2004 data is basically similar to the preceding years (ESHRE, 2001a,b, 2002, 2004, 2005, 2006, 2007).

As the data presented here are incomplete and generated through different methods using different definitions in different countries, interpretation of the data must be done with some caution.

Results

Number of treatment cycles

Table I shows the number of all treatment cycles recorded in each country, the number of clinics in the country and the number of clinics reporting to the register. The cycles are subdivided into treatment modalities such as IVF, ICSI, FER, ED, IVM and PDG/PGS. In Austria, Belgium, Germany, Iceland, Lithuania and Portugal, the number of oocyte recoveries was used, as the number of initiated cycles was not available. Totally, 785 clinics from 29 countries reported 367 066 cycles.

Table I.

ART in European countries in 2004.

Country IVF clinics in the country Treatment cycles 
 Clinics Clinics reporting IVF ICSI FER ED IVM PGD All 
Albania 51 72 123 
Austria 25 25 1220 3284     4504 
Belgium 18 18 4053 9741 4802 513  650 19 759 
Bulgaria 14 488 440 53 22 1003 
Denmark 21 21 5575 4023 1853 67   11 518 
Finland 18 18 2926 1835 3434 872 96 41 9204 
France 100 100 23 926 31 291 14 069 264  196 69 746 
Germany 120 120 12 211 26 613 17 989    56 813 
Greece 49 16 2793 5425 1115 381 96 9810 
Hungary 11 688 1905 256 28 2878 
Iceland 107 127 73 316 
Ireland 1267 847 466  2580 
Italy 218 133 7313 16 398 2388    26 099 
Latvia 88 50 44 184 
Lithuania 45 38  83 
Macedonia 299 222 522 
Norway 10 10 2799 2337 942 6078 
Poland 24 16 578 3097 1278 104 5059 
Portugal 19 17 848 1643 368 24 21 2904 
Russia C.I.S. 44 40 8595 3457 1755 944 34 87 14 872 
Serbia and Montenegro 12 27 154   187 
Slovenia 695 1405 567 19 34 2725 
Spain 182 84 5173 22 308 7312 4801  1362 40 956 
Sweden 15 15 4887 4706 3205 73   12 871 
Switzerland 20 19 664 2481 2573    5718 
The Netherlands 13 13 9178 6119    69 15 366 
Turkey 78 28 3444 67 36 3575 
Ukraine 15 11 1078 427 38 59  30 1632 
UK 74 74 17 072 13 303 7349 2150  107 39 981 
All 1121 785 114 672 167 192 71 997 10 334 170 2701 367 066 
Country IVF clinics in the country Treatment cycles 
 Clinics Clinics reporting IVF ICSI FER ED IVM PGD All 
Albania 51 72 123 
Austria 25 25 1220 3284     4504 
Belgium 18 18 4053 9741 4802 513  650 19 759 
Bulgaria 14 488 440 53 22 1003 
Denmark 21 21 5575 4023 1853 67   11 518 
Finland 18 18 2926 1835 3434 872 96 41 9204 
France 100 100 23 926 31 291 14 069 264  196 69 746 
Germany 120 120 12 211 26 613 17 989    56 813 
Greece 49 16 2793 5425 1115 381 96 9810 
Hungary 11 688 1905 256 28 2878 
Iceland 107 127 73 316 
Ireland 1267 847 466  2580 
Italy 218 133 7313 16 398 2388    26 099 
Latvia 88 50 44 184 
Lithuania 45 38  83 
Macedonia 299 222 522 
Norway 10 10 2799 2337 942 6078 
Poland 24 16 578 3097 1278 104 5059 
Portugal 19 17 848 1643 368 24 21 2904 
Russia C.I.S. 44 40 8595 3457 1755 944 34 87 14 872 
Serbia and Montenegro 12 27 154   187 
Slovenia 695 1405 567 19 34 2725 
Spain 182 84 5173 22 308 7312 4801  1362 40 956 
Sweden 15 15 4887 4706 3205 73   12 871 
Switzerland 20 19 664 2481 2573    5718 
The Netherlands 13 13 9178 6119    69 15 366 
Turkey 78 28 3444 67 36 3575 
Ukraine 15 11 1078 427 38 59  30 1632 
UK 74 74 17 072 13 303 7349 2150  107 39 981 
All 1121 785 114 672 167 192 71 997 10 334 170 2701 367 066 

For Austria, Belgium, Germany, Iceland, Lithuania and Portugal, 'treatment cycles' for IVF and ICSI refer to aspirations. FER refers to thawings, but for Latvia, it refers to transfers. ED refers to cycles where eggs were donated or to a cycle where donor eggs resulted in embryo transfer in a recipient. For Belgium, preimplantation genetic diagnosis (PGD) refers to transfers. IVM: in vitro maturation.

The proportion of IVF (114 672) and ICSI (167 192) cycles was 40.7% IVF versus 59.3% ICSI. The proportion of FER cycles compared with 'fresh' cycles were 71 997/281 864 (25.5%).

Table II shows data from those 14 countries where all clinics have reported to the register. The number of cycles is related to the total population in the country as well as to the number of females of reproductive age (15–49 years). Additionally, the number of infants born after ART is expressed as a percentage of the total number of live-born in the country. Overall, 248 937 cycles were undertaken in a population of 261.6 million, giving a mean of 1095 cycles per million. On average, 4 cycles per 1000 women of reproductive age were done. The proportion of infants born after ART in the 14 countries ranged from 0.2% to 4.2%.

Table II.

ART in those countries where all clinics reported to the national register in 2004.

Country Cycles Population Females of reproductive agea Cycles/million Cycles/thousand females of reproductive age ART deliveries ART infants National births ART infants (%) 
Austria 4504 8 174 762 1 968 000 551 233 304 72 755 0.4 
Belgium 19 109 10 348 276 2 438 000 1847 2320 2596 109 588 2.4 
Denmark 11 518 5 413 392 1 215 000 2128 2152 2616 62 741 4.2 
Finland 9204 5 214 512 1 188 000 1765 1562 1589 55 065 2.9 
France 69 746 60 424 213 14 306 000 1154 10 460 12 664 745634 1.7 
Germany 56 813 75 212 900 19 412 000 755 8458 10 270 643 822 1.6 
Iceland 316 293 906 50 000 1075 64 81 4065 2.0 
Latvia 184 2 306 306 564 000 80 27 33 20 457 0.2 
Macedonia 522 2 071 210 510 000 252 59 78 27 216 0.3 
Norway 6078 4 574 560 1 058 000 1329 1219 1512 54 392 2.8 
Slovenia 2725 2 011 473 490 000 1355 522 611 17 902 3.4 
Sweden 12 871 8 986 400 1 980 000 1432 2545 2711 93 998 2.9 
The Netherlands 15 366 16 318 199 3 854 000 942   186 191  
UK 39 981 60 270 708 14 335 000 663 8338 10 301 655 745 1.6 
All 248 937 261 620 817 63 368 000 1095   2 749 571  
Country Cycles Population Females of reproductive agea Cycles/million Cycles/thousand females of reproductive age ART deliveries ART infants National births ART infants (%) 
Austria 4504 8 174 762 1 968 000 551 233 304 72 755 0.4 
Belgium 19 109 10 348 276 2 438 000 1847 2320 2596 109 588 2.4 
Denmark 11 518 5 413 392 1 215 000 2128 2152 2616 62 741 4.2 
Finland 9204 5 214 512 1 188 000 1765 1562 1589 55 065 2.9 
France 69 746 60 424 213 14 306 000 1154 10 460 12 664 745634 1.7 
Germany 56 813 75 212 900 19 412 000 755 8458 10 270 643 822 1.6 
Iceland 316 293 906 50 000 1075 64 81 4065 2.0 
Latvia 184 2 306 306 564 000 80 27 33 20 457 0.2 
Macedonia 522 2 071 210 510 000 252 59 78 27 216 0.3 
Norway 6078 4 574 560 1 058 000 1329 1219 1512 54 392 2.8 
Slovenia 2725 2 011 473 490 000 1355 522 611 17 902 3.4 
Sweden 12 871 8 986 400 1 980 000 1432 2545 2711 93 998 2.9 
The Netherlands 15 366 16 318 199 3 854 000 942   186 191  
UK 39 981 60 270 708 14 335 000 663 8338 10 301 655 745 1.6 
All 248 937 261 620 817 63 368 000 1095   2 749 571  

Data refer to IVF, ICSI, FER and ED combined.

aNumbers of the year 2005.

Size of the clinics

Table III shows the size distribution of the 785 reporting clinics. The size of a clinic (or unit) is based on all cycles performed per year.

Table III.

Size of the IVF clinics reporting to the register in 2004.

Country IVF clinics in the country Size of clinics (cycles per year) 
 All Reporting <100 100–199 200–499 500–1000 >1000 
Albania 100 
Austriaa 25 25           
Belgium 18 18 39 44 
Bulgaria 14 43 29 29 
Denmark 21 21 24 24 33 19 
Finland 18 18 11 50 22 11 
France 100 100 10 10 30 30 34 34 17 17 
Germany 120 120 20 17 21 17 37 31 20 16 22 18 
Greece 49 16 12 50 18 12 
Hungary 11 83 16 
Iceland 100 
Ireland 33 33 17 17 
Italy 218 133 53 40 34 26 36 27 
Latvia 33 33 33 
Lithuania 100 
Macedonia 50 50 
Norway 10 10 10 30 40 20 
Poland 24 16 37 19 37 
Portugal 19 17 29 41 23 
Russia C.I.S. 44 40 22 20 10 25 10 25 
Serbia and Montenegro 12 100 
Slovenia 33 67 
Spain 182 84 16 19 16 19 32 38 11 13 11 
Sweden 15 15 27 40 27 
Switzerland 20 19 21 26 32 16 
The Netherlands 13 13 31 61 
Turkey 78 25 25 50 
Ukraine 15 11 45 27 27 
UK 74 74 11 29 40 20 27 11 15 
All 1096 760 145 19 131 17 237 31 146 19 101 13 
Country IVF clinics in the country Size of clinics (cycles per year) 
 All Reporting <100 100–199 200–499 500–1000 >1000 
Albania 100 
Austriaa 25 25           
Belgium 18 18 39 44 
Bulgaria 14 43 29 29 
Denmark 21 21 24 24 33 19 
Finland 18 18 11 50 22 11 
France 100 100 10 10 30 30 34 34 17 17 
Germany 120 120 20 17 21 17 37 31 20 16 22 18 
Greece 49 16 12 50 18 12 
Hungary 11 83 16 
Iceland 100 
Ireland 33 33 17 17 
Italy 218 133 53 40 34 26 36 27 
Latvia 33 33 33 
Lithuania 100 
Macedonia 50 50 
Norway 10 10 10 30 40 20 
Poland 24 16 37 19 37 
Portugal 19 17 29 41 23 
Russia C.I.S. 44 40 22 20 10 25 10 25 
Serbia and Montenegro 12 100 
Slovenia 33 67 
Spain 182 84 16 19 16 19 32 38 11 13 11 
Sweden 15 15 27 40 27 
Switzerland 20 19 21 26 32 16 
The Netherlands 13 13 31 61 
Turkey 78 25 25 50 
Ukraine 15 11 45 27 27 
UK 74 74 11 29 40 20 27 11 15 
All 1096 760 145 19 131 17 237 31 146 19 101 13 

aData from Austria are not included in the total.

The distribution of clinics according to the number of cycles varies considerably among the countries. Among the larger countries, it could be noted that in Italy 40% of the clinics provided fewer than 100 cycles annually, whereas in Belgium 44% of the clinics performed more than 1000 cycles a year.

To what extent these variations may influence results cannot be estimated from the present report.

Age distribution

Table IV shows the age distribution of those women treated with IVF or ICSI in various countries.

Table IV.

Age distribution (years) of women treated with IVF and ICSI in 2004.

Country IVF (%) ICSI (%) 
 ≤29 30–34 35–39 40–44 ≥45 ≤29 30–34 35–39 40–44 ≥45 
Albania 31.4 27.5 33.3 7.8 0.0 29.2 27.8 30.6 9.7 2.8 
Austria           
Belgium 22.0 37.5 27.7 12.5 0.4 25.4 35.6 27.4 11.2 0.5 
Bulgaria 26.1 42.0 21.8 8.4 1.6 26.9 40.4 26.7 5.5 0.5 
Denmark 20.6 36.2 30.6 11.9 0.8 25.2 39.4 26.9 8.0 0.5 
Finland 22.8 31.6 32.0 13.7 0.0 24.2 35.1 31.1 9.1 0.4 
France 14.3 36.3 33.9 15.2 0.3 22.0 39.5 27.9 10.4 0.2 
Germany 14.7 32.4 40.6 11.6 0.7 17.6 34.6 37.3 9.9 0.6 
Greece 13.1 26.7 39.3 17.5 3.5 12.0 29.0 37.2 17.4 4.4 
Hungary 21.2 39.5 24.9 13.1 1.4 29.6 33.3 26.8 8.9 1.3 
Iceland 19.6 31.8 34.6 14.0 0.0 21.3 33.1 30.7 15.0 0.0 
Ireland 5.3 23.9 48.1 22.0 0.6 12.9 30.2 43.5 13.2 0.2 
Italy 9.5 29.5 40.0 18.6 2.4 11.9 29.1 37.5 18.5 2.9 
Latvia 22.7 31.8 25.0 18.2 2.3 16.0 46.0 32.0 4.0 2.0 
Lithuania 11.1 37.8 26.7 17.8 6.7 23.7 36.8 28.9 7.9 2.6 
Macedonia 18.9 31.3 35.6 12.1 2.1 23.3 28.8 30.4 16.3 1.3 
Norway 17.4 42.9 31.4 8.3 0.0 21.3 41.0 31.0 6.7 0.0 
Poland 22.0 46.5 24.6 6.4 0.5 22.9 41.7 24.2 10.1 1.1 
Portugal 15.1 44.8 33.5 6.5 0.1 19.6 40.7 30.0 8.9 0.7 
Russia C.I.S. 26.0 39.4 23.9 8.7 1.9 28.0 35.7 22.5 11.3 2.5 
Serbia and Montenegro 9.5 14.3 28.6 47.6 0.0 9.1 26.6 41.6 16.9 5.8 
Slovenia 19.6 36.5 32.2 11.7 0.0 17.7 35.6 29.1 17.4 0.1 
Spain 7.6 34.5 45.2 12.2 0.7 9.6 36.4 42.6 10.7 0.6 
Sweden 12.8 35.0 37.8 14.4 0.0 16.5 35.3 36.8 11.4 0.0 
Switzerland 8.6 31.0 44.1 15.2 1.2 13.5 32.1 40.2 13.7 0.6 
The Netherlands           
Turkey 10.7 60.7 25.0 3.6 0.0 31.8 33.2 24.7 9.7 0.6 
Ukraine 29.1 36.9 27.5 6.4 0.1 37.9 33.5 18.5 9.6 0.5 
UK 10.8 31.8 40.9 15.5 1.0 14.4 34.6 37.7 12.7 0.6 
All 17.1 35.2 32.9 13.7 1.0 20.9 35.0 31.6 11.3 1.2 
Country IVF (%) ICSI (%) 
 ≤29 30–34 35–39 40–44 ≥45 ≤29 30–34 35–39 40–44 ≥45 
Albania 31.4 27.5 33.3 7.8 0.0 29.2 27.8 30.6 9.7 2.8 
Austria           
Belgium 22.0 37.5 27.7 12.5 0.4 25.4 35.6 27.4 11.2 0.5 
Bulgaria 26.1 42.0 21.8 8.4 1.6 26.9 40.4 26.7 5.5 0.5 
Denmark 20.6 36.2 30.6 11.9 0.8 25.2 39.4 26.9 8.0 0.5 
Finland 22.8 31.6 32.0 13.7 0.0 24.2 35.1 31.1 9.1 0.4 
France 14.3 36.3 33.9 15.2 0.3 22.0 39.5 27.9 10.4 0.2 
Germany 14.7 32.4 40.6 11.6 0.7 17.6 34.6 37.3 9.9 0.6 
Greece 13.1 26.7 39.3 17.5 3.5 12.0 29.0 37.2 17.4 4.4 
Hungary 21.2 39.5 24.9 13.1 1.4 29.6 33.3 26.8 8.9 1.3 
Iceland 19.6 31.8 34.6 14.0 0.0 21.3 33.1 30.7 15.0 0.0 
Ireland 5.3 23.9 48.1 22.0 0.6 12.9 30.2 43.5 13.2 0.2 
Italy 9.5 29.5 40.0 18.6 2.4 11.9 29.1 37.5 18.5 2.9 
Latvia 22.7 31.8 25.0 18.2 2.3 16.0 46.0 32.0 4.0 2.0 
Lithuania 11.1 37.8 26.7 17.8 6.7 23.7 36.8 28.9 7.9 2.6 
Macedonia 18.9 31.3 35.6 12.1 2.1 23.3 28.8 30.4 16.3 1.3 
Norway 17.4 42.9 31.4 8.3 0.0 21.3 41.0 31.0 6.7 0.0 
Poland 22.0 46.5 24.6 6.4 0.5 22.9 41.7 24.2 10.1 1.1 
Portugal 15.1 44.8 33.5 6.5 0.1 19.6 40.7 30.0 8.9 0.7 
Russia C.I.S. 26.0 39.4 23.9 8.7 1.9 28.0 35.7 22.5 11.3 2.5 
Serbia and Montenegro 9.5 14.3 28.6 47.6 0.0 9.1 26.6 41.6 16.9 5.8 
Slovenia 19.6 36.5 32.2 11.7 0.0 17.7 35.6 29.1 17.4 0.1 
Spain 7.6 34.5 45.2 12.2 0.7 9.6 36.4 42.6 10.7 0.6 
Sweden 12.8 35.0 37.8 14.4 0.0 16.5 35.3 36.8 11.4 0.0 
Switzerland 8.6 31.0 44.1 15.2 1.2 13.5 32.1 40.2 13.7 0.6 
The Netherlands           
Turkey 10.7 60.7 25.0 3.6 0.0 31.8 33.2 24.7 9.7 0.6 
Ukraine 29.1 36.9 27.5 6.4 0.1 37.9 33.5 18.5 9.6 0.5 
UK 10.8 31.8 40.9 15.5 1.0 14.4 34.6 37.7 12.7 0.6 
All 17.1 35.2 32.9 13.7 1.0 20.9 35.0 31.6 11.3 1.2 

Austria and The Netherlands: no data available. For Finland in eight women, the age was missing. Data for women aged 45 years or more are included in the age group of 40–44 years. For France, it was estimated from the Fivnat register. For Germany, data were missing in two cycles. For Italy, the age was not reported in 503 IVF cycles and 383 ICSI cycles. For Russia, the age was missing in 403 IVF, 146 ICSI and 13 egg donation cycles. For the UK, data were missing in 17 IVF cycles, 20 ICSI cycles and 1 egg donation cycle. The age distribution of women receiving ED was known in 59 548 cases (<29 years 16.5%, 30–34 years 34.4%, 35–39 years 30.2%, 40–44 years 16.0% and >45 years 2.8%).

Number of embryos transferred

Table V shows the number of embryos transferred after IVF and ICSI combined. The total number of single embryo transfers (SETs) was 43 219 (19.2%), dual embryo transfers (DETs) 124 797 (55.3%), triple embryo transfers 49 843 (22.1%) and four or more embryo transfers 7511 (3.3%). As indicated in this table, major differences were seen between countries. In 2004, several countries reported an increase of SETs. The highest levels were found in Finland (47%), Belgium (49%) and Sweden (67%). The proportion of triple embryo transfers was 0.1% in Sweden to 50% in Lithuania. Transfer of four or more embryos ranged from zero in several countries to 33.2% in Turkey.

Table V.

Number of embryos transferred after IVF and ICSI in 2004.

Country All transfers 1 embryo 2 embryos 3 embryos 4+ embryos 
Albania 102 10 9.8 22 21.6 22 21.6 48 47.1 
Austria 4315 632 14.6 2743 63.6 878 20.3 62 1.4 
Belgium 12 787 6247 48.9 5379 42.1 972 7.6 189 1.5 
Bulgaria 855 64 7.5 240 28.1 419 49.0 132 15.4 
Denmark 7795 2134 27.4 5259 67.5 402 5.2 0.0 
Finland 4176 1953 46.8 2191 52.5 11 0.3 0.0 
France 43 821 7689 17.5 25 917 59.1 8176 18.7 2039 4.7 
Germany 35 951 4176 11.6 22 029 61.3 9746 27.1 0.0 
Greece 6953 1005 14.5 1640 23.6 2788 40.1 1520 21.9 
Hungary 2334 175 7.5 651 27.9 1055 45.2 453 19.4 
Iceland 199 42 21.1 132 66.3 25 12.6 0.0 
Ireland (Rep.) 1705 134 7.9 1330 78.0 218 12.8 23 1.3 
Italy 18 521 3382 18.3 5989 32.3 8983 48.5 167 0.9 
Latvia 120 23 19.2 64 53.3 33 27.5 0.0 
Lithuania 76 11.8 13 17.1 38 50.0 16 21.1 
Macedonia 407 86 21.1 124 30.5 151 37.1 46 11.3 
Norway 4554 1161 25.5 3377 74.2 16 0.4 0.0 
Poland 3344 433 12.9 2170 64.9 661 19.8 80 2.4 
Portugal 2257 335 14.9 1272 56.5 600 26.7 43 1.9 
Russia C.I.S. 10 904 1436 13.2 5194 47.6 3049 28.0 1214 11.1 
Serbia and Montenegro 126 29 23.0 18 14.3 32 25.4 47 37.3 
Slovenia 1787 474 26.5 1090 61.0 223 12.5 0.0 
Spain 21 085 2798 13.3 10 500 49.8 7787 36.9 0.0 
Sweden 8135 5486 67.4 2642 32.5 0.1 0.0 
Switzerland 2752 344 12.5 1782 64.8 525 19.1 0.1 
The Netherlandsa 12 474         
Turkey 3015 277 9.2 551 18.3 1185 39.3 1002 33.2 
Ukraine 1339 233 17.4 283 21.1 396 29.6 427 31.9 
UK 26 092 2452 9.4 22 195 85.1 1445 5.5 0.0 
All 225507 43 219 19.2 124797 55.3 49 843 22.1 7511 3.3 
Country All transfers 1 embryo 2 embryos 3 embryos 4+ embryos 
Albania 102 10 9.8 22 21.6 22 21.6 48 47.1 
Austria 4315 632 14.6 2743 63.6 878 20.3 62 1.4 
Belgium 12 787 6247 48.9 5379 42.1 972 7.6 189 1.5 
Bulgaria 855 64 7.5 240 28.1 419 49.0 132 15.4 
Denmark 7795 2134 27.4 5259 67.5 402 5.2 0.0 
Finland 4176 1953 46.8 2191 52.5 11 0.3 0.0 
France 43 821 7689 17.5 25 917 59.1 8176 18.7 2039 4.7 
Germany 35 951 4176 11.6 22 029 61.3 9746 27.1 0.0 
Greece 6953 1005 14.5 1640 23.6 2788 40.1 1520 21.9 
Hungary 2334 175 7.5 651 27.9 1055 45.2 453 19.4 
Iceland 199 42 21.1 132 66.3 25 12.6 0.0 
Ireland (Rep.) 1705 134 7.9 1330 78.0 218 12.8 23 1.3 
Italy 18 521 3382 18.3 5989 32.3 8983 48.5 167 0.9 
Latvia 120 23 19.2 64 53.3 33 27.5 0.0 
Lithuania 76 11.8 13 17.1 38 50.0 16 21.1 
Macedonia 407 86 21.1 124 30.5 151 37.1 46 11.3 
Norway 4554 1161 25.5 3377 74.2 16 0.4 0.0 
Poland 3344 433 12.9 2170 64.9 661 19.8 80 2.4 
Portugal 2257 335 14.9 1272 56.5 600 26.7 43 1.9 
Russia C.I.S. 10 904 1436 13.2 5194 47.6 3049 28.0 1214 11.1 
Serbia and Montenegro 126 29 23.0 18 14.3 32 25.4 47 37.3 
Slovenia 1787 474 26.5 1090 61.0 223 12.5 0.0 
Spain 21 085 2798 13.3 10 500 49.8 7787 36.9 0.0 
Sweden 8135 5486 67.4 2642 32.5 0.1 0.0 
Switzerland 2752 344 12.5 1782 64.8 525 19.1 0.1 
The Netherlandsa 12 474         
Turkey 3015 277 9.2 551 18.3 1185 39.3 1002 33.2 
Ukraine 1339 233 17.4 283 21.1 396 29.6 427 31.9 
UK 26 092 2452 9.4 22 195 85.1 1445 5.5 0.0 
All 225507 43 219 19.2 124797 55.3 49 843 22.1 7511 3.3 

Data restricted to those transfers where the number of embryos transferred is known. Finland: no data available for 16 IVF cycles and 5 ICSI cycles. Portugal: no data available for 7 ICSI cycles. Russia: no data available for 7 IVF cycles and 4 ICSI cycles, Switzerland: no data available for 5 IVF cycles and 93 ICSI cycles.

aTotal excludes transfers from The Netherlands and Norway as the number of embryos transferred is not known for these countries.

Pregnancies and deliveries after treatment

Tables VI–IX show the number of pregnancies and deliveries in relation to the number of initiated cycles, aspirations and transfers, for IVF (Table VI), ICSI (Table VIII), FER (Table VIII) and ED (Table IX).

Table VI.

Pregnancies and deliveries after IVF in 2004.

Country Cycles Aspirations Transfers Clinical pregnancies Deliveries Pregnancies per cycle (%) Pregnancies per aspiration (%) Pregnancies per transfer (%) Deliveries per cycle (%) Deliveries per aspiration (%) Deliveries per transfer (%) 
Albania 51 51 45 11 21.6 21.6 24.4 7.8 7.8 8.9 
Austria  1220  367 233  30.1   19.1  
Belgium  4053 3707 870 549  21.5 23.5  13.5 14.8 
Bulgaria 488 467 443 108 76 22.1 23.1 24.4 15.6 16.3 17.2 
Denmark 5575 5299 4466 1479 1144 26.5 27.9 33.1 20.5 21.6 25.6 
Finland 2926 2849 2530 676 530 23.1 23.7 26.7 18.1 18.6 20.9 
France 23 926 21 749 18 365 4938 3756 20.6 22.7 26.9 15.7 17.3 20.5 
Germany  12 211 10 920 3139 2003  25.7 28.7  16.4 18.3 
Greece 2793 2662 2391 862 416 30.9 32.4 36.1 14.9 15.6 17.4 
Hungary 688 639 609 201 145 29.2 31.5 33.0 21.1 22.7 23.8 
Iceland  107 89 28 23  26.2 31.5  21.5 25.8 
Ireland (Rep.) 1267 1079 979 298 233 23.5 27.6 30.4 18.4 21.6 23.8 
Italy 7313 6233 5372 1396 866 19.1 22.4 26.0 11.8 13.9 16.1 
Latvia 88 85 76 31 14 35.2 36.5 40.8 15.9 16.5 18.4 
Lithuania  45 39 11  24.4 28.2  11.1 12.8 
Macedonia 299 283 229 75 46 25.1 26.5 32.8 15.4 16.3 20.1 
Norway 2799 2692 2452 790 655 28.2 29.3 32.2 23.4 24.3 26.7 
Poland 578 550 494 182 94 31.5 33.1 36.8 16.3 17.1 19.0 
Portugal  848 763 246 168  29.0 32.2  19.8 22.0 
Russia C.I.S. 8595 8281 7700 2641 1524 30.7 31.9 34.3 17.7 18.4 19.8 
Serbia/Montenegro 27 11  7.4 18.2 100.0    
Slovenia 695 656 582 181 142 26.0 27.6 31.1 20.4 21.6 24.4 
Spain 5173 4537 3599 1441 657 27.9 31.8 40.0 12.7 14.5 18.3 
Sweden 4887 4490 4050 1355 1069 27.7 30.2 33.5 21.9 23.8 26.4 
Switzerland 664 645 605 169 124 25.5 26.2 27.9 18.7 19.2 20.5 
The Netherlands 9178 8273 7258 2450  26.7 29.6 33.8    
Turkey 28 23 21 11 11 39.3 47.8 52.4 39.3 47.8 52.4 
Ukraine 1078 1023 947 261 205 24.2 25.5 27.6 19.0 20.0 21.6 
UK 17 072 14 898 13 622 3993 3500 23.4 26.8 29.3 20.5 23.5 25.7 
All  104 739a 92 355 27 845a   26.6 30.1    
Country Cycles Aspirations Transfers Clinical pregnancies Deliveries Pregnancies per cycle (%) Pregnancies per aspiration (%) Pregnancies per transfer (%) Deliveries per cycle (%) Deliveries per aspiration (%) Deliveries per transfer (%) 
Albania 51 51 45 11 21.6 21.6 24.4 7.8 7.8 8.9 
Austria  1220  367 233  30.1   19.1  
Belgium  4053 3707 870 549  21.5 23.5  13.5 14.8 
Bulgaria 488 467 443 108 76 22.1 23.1 24.4 15.6 16.3 17.2 
Denmark 5575 5299 4466 1479 1144 26.5 27.9 33.1 20.5 21.6 25.6 
Finland 2926 2849 2530 676 530 23.1 23.7 26.7 18.1 18.6 20.9 
France 23 926 21 749 18 365 4938 3756 20.6 22.7 26.9 15.7 17.3 20.5 
Germany  12 211 10 920 3139 2003  25.7 28.7  16.4 18.3 
Greece 2793 2662 2391 862 416 30.9 32.4 36.1 14.9 15.6 17.4 
Hungary 688 639 609 201 145 29.2 31.5 33.0 21.1 22.7 23.8 
Iceland  107 89 28 23  26.2 31.5  21.5 25.8 
Ireland (Rep.) 1267 1079 979 298 233 23.5 27.6 30.4 18.4 21.6 23.8 
Italy 7313 6233 5372 1396 866 19.1 22.4 26.0 11.8 13.9 16.1 
Latvia 88 85 76 31 14 35.2 36.5 40.8 15.9 16.5 18.4 
Lithuania  45 39 11  24.4 28.2  11.1 12.8 
Macedonia 299 283 229 75 46 25.1 26.5 32.8 15.4 16.3 20.1 
Norway 2799 2692 2452 790 655 28.2 29.3 32.2 23.4 24.3 26.7 
Poland 578 550 494 182 94 31.5 33.1 36.8 16.3 17.1 19.0 
Portugal  848 763 246 168  29.0 32.2  19.8 22.0 
Russia C.I.S. 8595 8281 7700 2641 1524 30.7 31.9 34.3 17.7 18.4 19.8 
Serbia/Montenegro 27 11  7.4 18.2 100.0    
Slovenia 695 656 582 181 142 26.0 27.6 31.1 20.4 21.6 24.4 
Spain 5173 4537 3599 1441 657 27.9 31.8 40.0 12.7 14.5 18.3 
Sweden 4887 4490 4050 1355 1069 27.7 30.2 33.5 21.9 23.8 26.4 
Switzerland 664 645 605 169 124 25.5 26.2 27.9 18.7 19.2 20.5 
The Netherlands 9178 8273 7258 2450  26.7 29.6 33.8    
Turkey 28 23 21 11 11 39.3 47.8 52.4 39.3 47.8 52.4 
Ukraine 1078 1023 947 261 205 24.2 25.5 27.6 19.0 20.0 21.6 
UK 17 072 14 898 13 622 3993 3500 23.4 26.8 29.3 20.5 23.5 25.7 
All  104 739a 92 355 27 845a   26.6 30.1    

The recording of deliveries is incomplete, see Table X. Data on initiated cycles not available for Austria, Belgium, Germany, Iceland, Lithuania and Portugal. Data on transfers are not available for Austria. Data on deliveries are not available for Serbia and Montenegro and The Netherlands. For Greece in 140 pregnancies, no further data were available. For Russia in 611 pregnancies, no further data were available.

aTotal excludes aspirations and clinical pregnancies from Austria, as the set of data was incomplete. Note that the recording of deliveries is incomplete due to loss of follow-up in several countries.

Table VII.

Pregnancies and deliveries after ICSI in 2004.

Country Cycles Aspirations Transfers Clinical pregnancies Deliveries Pregnancies per cycle (%) Pregnancies per aspiration (%) Pregnancies per transfer (%) Deliveries per cycle (%) Deliveries per aspiration (%) Deliveries per transfer (%) 
Albania 72 59 57 14 19.4 23.7 24.6 8.3 10.2 10.5 
Austria  3284  953   29.0     
Belgium  9741 9045 1944 1253  20.0 21.5  12.9 13.9 
Bulgaria 440 318 412 148 135 33.6 46.5 35.9 30.7 42.5 32.8 
Denmark 4023 3915 3329 1084 836 26.9 27.7 32.6 20.8 21.4 25.1 
Finland 1835 1798 1646 457 356 24.9 25.4 27.8 19.4 19.8 21.6 
France 31 291 28 443 25 456 6758 5205 21.6 23.8 26.5 16.6 18.3 20.4 
Germany  26 613 25 031 7113 4696  26.7 28.4  17.6 18.8 
Greece 5425 5189 4562 1664 818 30.7 32.1 36.5 15.1 15.8 17.9 
Hungary 1905 1859 1725 594 459 31.2 32.0 34.4 24.1 24.7 26.6 
Iceland  127 110 35 30  27.6 31.8  23.6 27.3 
Ireland (Rep.) 847 758 726 211 161 24.9 27.8 29.1 19.0 21.2 22.2 
Italy 16 398 14 735 13 149 3430 2140 20.9 23.3 26.1 13.1 14.5 16.3 
Latvia 50 49 44 20 40.0 40.8 45.5 16.0 16.3 18.2 
Lithuania  38 37 10  26.3 27.0  13.2 13.5 
Macedonia 222 206 178 26 13 11.7 12.6 14.6 5.9 6.3 7.3 
Norway 2337 2260 2102 568 446 24.3 25.1 27.0 19.1 19.7 21.2 
Poland 3097 3042 2850 1005 748 32.5 33.0 35.3 24.2 24.6 26.2 
Portugal  1643 1494 405 309  24.7 27.1  18.8 20.7 
Russia C.I.S. 3457 3375 3204 1057 585 30.6 31.3 33.0 16.9 17.3 18.3 
Serbia/Montenegro 154 149 124 44  28.6 29.5 35.5    
Slovenia 1405 1360 1205 372 302 26.5 27.4 30.9 21.5 22.2 25.1 
Spain 22 308 19 778 17 486 6425 3161 28.8 32.5 36.7 14.2 16.0 18.1 
Sweden 4706 4492 4085 1211 958 25.7 27.0 29.6 20.4 21.3 23.5 
Switzerland 2481 2279 2147 563 404 22.7 24.7 26.2 16.3 17.7 18.8 
The Netherlands 6119 5686 5216 1801  29.4 31.7 34.5 0.0 0.0 0.0 
Turkey 3444 3254 2994 1327 559 38.5 40.8 44.3 16.2 17.2 18.7 
Ukraine 427 416 392 114 99 26.7 27.4 29.1 23.2 23.8 25.3 
UK 13 303 13 275 12 470 3640 3247 27.4 27.4 29.2 24.4 24.5 26.0 
All  154 857 141 276 42 040   27.1 29.8    
Country Cycles Aspirations Transfers Clinical pregnancies Deliveries Pregnancies per cycle (%) Pregnancies per aspiration (%) Pregnancies per transfer (%) Deliveries per cycle (%) Deliveries per aspiration (%) Deliveries per transfer (%) 
Albania 72 59 57 14 19.4 23.7 24.6 8.3 10.2 10.5 
Austria  3284  953   29.0     
Belgium  9741 9045 1944 1253  20.0 21.5  12.9 13.9 
Bulgaria 440 318 412 148 135 33.6 46.5 35.9 30.7 42.5 32.8 
Denmark 4023 3915 3329 1084 836 26.9 27.7 32.6 20.8 21.4 25.1 
Finland 1835 1798 1646 457 356 24.9 25.4 27.8 19.4 19.8 21.6 
France 31 291 28 443 25 456 6758 5205 21.6 23.8 26.5 16.6 18.3 20.4 
Germany  26 613 25 031 7113 4696  26.7 28.4  17.6 18.8 
Greece 5425 5189 4562 1664 818 30.7 32.1 36.5 15.1 15.8 17.9 
Hungary 1905 1859 1725 594 459 31.2 32.0 34.4 24.1 24.7 26.6 
Iceland  127 110 35 30  27.6 31.8  23.6 27.3 
Ireland (Rep.) 847 758 726 211 161 24.9 27.8 29.1 19.0 21.2 22.2 
Italy 16 398 14 735 13 149 3430 2140 20.9 23.3 26.1 13.1 14.5 16.3 
Latvia 50 49 44 20 40.0 40.8 45.5 16.0 16.3 18.2 
Lithuania  38 37 10  26.3 27.0  13.2 13.5 
Macedonia 222 206 178 26 13 11.7 12.6 14.6 5.9 6.3 7.3 
Norway 2337 2260 2102 568 446 24.3 25.1 27.0 19.1 19.7 21.2 
Poland 3097 3042 2850 1005 748 32.5 33.0 35.3 24.2 24.6 26.2 
Portugal  1643 1494 405 309  24.7 27.1  18.8 20.7 
Russia C.I.S. 3457 3375 3204 1057 585 30.6 31.3 33.0 16.9 17.3 18.3 
Serbia/Montenegro 154 149 124 44  28.6 29.5 35.5    
Slovenia 1405 1360 1205 372 302 26.5 27.4 30.9 21.5 22.2 25.1 
Spain 22 308 19 778 17 486 6425 3161 28.8 32.5 36.7 14.2 16.0 18.1 
Sweden 4706 4492 4085 1211 958 25.7 27.0 29.6 20.4 21.3 23.5 
Switzerland 2481 2279 2147 563 404 22.7 24.7 26.2 16.3 17.7 18.8 
The Netherlands 6119 5686 5216 1801  29.4 31.7 34.5 0.0 0.0 0.0 
Turkey 3444 3254 2994 1327 559 38.5 40.8 44.3 16.2 17.2 18.7 
Ukraine 427 416 392 114 99 26.7 27.4 29.1 23.2 23.8 25.3 
UK 13 303 13 275 12 470 3640 3247 27.4 27.4 29.2 24.4 24.5 26.0 
All  154 857 141 276 42 040   27.1 29.8    

The recording of deliveries is incomplete, see Table X. Data on initiated cycles not available for Austria, Belgium, Germany, Iceland and Lithuania and Portugal. Data on transfers are not available for Austria. Data on deliveries are not available for Austria, Serbia and Montenegro and The Netherlands. For Greece in 227 pregnancies, no further data were available. For Russia in 282 pregnancies, no further data were available.

Note that the recording of deliveries is incomplete due to loss of follow-up in several countries.

Table VIII.

Pregnancies and deliveries after FER (IVF and ICSI combined) in 2004.

Country Thawings Transfers Clinical pregnancies Deliveries Pregnancies per thawing (%) Pregnancies per transfer (%) Deliveries per thawing (%) Deliveries per transfer (%) 
Albania     
Austria         
Belgium 4802 3825 510 394 10.6 13.3 8.2 10.3 
Bulgaria 53 45 15.1 17.8 7.5 8.9 
Denmark 1853 1384 256 158 13.8 18.5 8.5 11.4 
Finland 3434 3037 715 518 20.8 23.5 15.1 17.1 
France 14 069 12 072 1983 1424 14.1 16.4 10.1 11.8 
Germany 17 989 17 043 2947 1759 16.4 17.3 9.8 10.3 
Greece 1115 1081 334 182 30.0 30.9 16.3 16.8 
Hungary 256 248 78 58 30.5 31.5 22.7 23.4 
Iceland 73 73 17 23.3 23.3 12.3 12.3 
Ireland (Rep.) 466 406 105 71 22.5 25.9 15.2 17.5 
Italy 2388 2201 407 260 17.0 18.5 10.9 11.8 
Latvia 44 44 15.9 15.9 11.4 11.4 
Lithuania   14.3  0.0 
Macedonia  0.0 0.0   
Norway 942 829 164 124 17.4 19.8 13.2 15.0 
Poland 1278 1166 209 111 16.4 17.9 8.7 9.5 
Portugal 368 330 58 29 15.8 17.6 7.9 8.8 
Russia C.I.S. 1755 1564 337 194 19.2 21.5 11.1 12.4 
Serbia/Montenegro         
Slovenia 567 532 92 76 16.2 17.3 13.4 14.3 
Spain 7312 4475 1229 537 16.8 27.5 7.3 12.0 
Sweden 3205 2696 686 498 21.4 25.4 15.5 18.5 
Switzerland 2573 2408 446 317 17.3 18.5 12.3 13.2 
The Netherlands  2023 425   21.0   
Turkey 67 65 9.0 9.2 3.0 3.1 
Ukraine 38 29 11 11 28.9 37.9 28.9 37.9 
UK 7349 6563 1244 1072 16.9 19.0 14.6 16.3 
All  64 147 12 275   19.1   
Country Thawings Transfers Clinical pregnancies Deliveries Pregnancies per thawing (%) Pregnancies per transfer (%) Deliveries per thawing (%) Deliveries per transfer (%) 
Albania     
Austria         
Belgium 4802 3825 510 394 10.6 13.3 8.2 10.3 
Bulgaria 53 45 15.1 17.8 7.5 8.9 
Denmark 1853 1384 256 158 13.8 18.5 8.5 11.4 
Finland 3434 3037 715 518 20.8 23.5 15.1 17.1 
France 14 069 12 072 1983 1424 14.1 16.4 10.1 11.8 
Germany 17 989 17 043 2947 1759 16.4 17.3 9.8 10.3 
Greece 1115 1081 334 182 30.0 30.9 16.3 16.8 
Hungary 256 248 78 58 30.5 31.5 22.7 23.4 
Iceland 73 73 17 23.3 23.3 12.3 12.3 
Ireland (Rep.) 466 406 105 71 22.5 25.9 15.2 17.5 
Italy 2388 2201 407 260 17.0 18.5 10.9 11.8 
Latvia 44 44 15.9 15.9 11.4 11.4 
Lithuania   14.3  0.0 
Macedonia  0.0 0.0   
Norway 942 829 164 124 17.4 19.8 13.2 15.0 
Poland 1278 1166 209 111 16.4 17.9 8.7 9.5 
Portugal 368 330 58 29 15.8 17.6 7.9 8.8 
Russia C.I.S. 1755 1564 337 194 19.2 21.5 11.1 12.4 
Serbia/Montenegro         
Slovenia 567 532 92 76 16.2 17.3 13.4 14.3 
Spain 7312 4475 1229 537 16.8 27.5 7.3 12.0 
Sweden 3205 2696 686 498 21.4 25.4 15.5 18.5 
Switzerland 2573 2408 446 317 17.3 18.5 12.3 13.2 
The Netherlands  2023 425   21.0   
Turkey 67 65 9.0 9.2 3.0 3.1 
Ukraine 38 29 11 11 28.9 37.9 28.9 37.9 
UK 7349 6563 1244 1072 16.9 19.0 14.6 16.3 
All  64 147 12 275   19.1   

The recording of deliveries is incomplete, see Table XI. Data on the number of thawings are not available for Austria, Lithuania, Serbia and Montenegro and The Netherlands. Data on transfers and pregnancies are not available for Austria and The Netherlands. Data on deliveries are not available for Austria, Macedonia, Serbia and Montenegro and The Netherlands. For Greece in 21 pregnancies, no further data were available. For Russia in 66 pregnancies, no further data were available.

Note that the recording of deliveries is incomplete due to loss of follow-up in several countries.

Table IX.

Pregnancies and deliveries after ED in 2004.

Country Donation Transfers Clinical pregnancies Deliveries Pregnancies per donation (%) Pregnancies per transfer (%) Deliveries per donation (%) Deliveries per transfer (%) 
Albania     
Austria         
Belgium 513 477 81 73 15.8 17.0 14.2 15.3 
Bulgaria 22 21 18.2 19.0 13.6 14.3 
Denmark 67 58 22 14 32.8 37.9 20.9 24.1 
Finland 872 820 216 152 24.8 26.3 17.4 18.5 
France 264 231 67 48 25.4 29.0 18.2 20.8 
Germany         
Greece 381 269 107 83 28.1 39.8 21.8 30.9 
Hungary 28 28 10 35.7 35.7 32.1 32.1 
Iceland 22.2 25.0 22.2 25.0 
Ireland (Rep.)     
Italy         
Latvia 50.0 50.0 0.0 0.0 
Lithuania     
Macedonia     
Norway     
Poland 104 100 33 17 31.7 33.0 16.3 17.0 
Portugal 24 21 12 50.0 57.1 33.3 38.1 
Russia C.I.S. 944 910 322 205 34.1 35.4 21.7 22.5 
Serbia/Montenegro 0.0 0.0 0.0 0.0 
Slovenia 19 17 15.8 17.6 10.5 11.8 
Spain 4801 4219 2190 1151 45.6 51.9 24.0 27.3 
Sweden 73 97 28 20 38.4 28.9 27.4 20.6 
Switzerland         
The Netherlands         
Turkey     
Ukraine 59 57 27 23 45.8 47.4 39.0 40.4 
UK 2150 1959 582 502 27.1 29.7 23.3 25.6 
All 10 334 9296 3707 2312 35.6 39.6   
Country Donation Transfers Clinical pregnancies Deliveries Pregnancies per donation (%) Pregnancies per transfer (%) Deliveries per donation (%) Deliveries per transfer (%) 
Albania     
Austria         
Belgium 513 477 81 73 15.8 17.0 14.2 15.3 
Bulgaria 22 21 18.2 19.0 13.6 14.3 
Denmark 67 58 22 14 32.8 37.9 20.9 24.1 
Finland 872 820 216 152 24.8 26.3 17.4 18.5 
France 264 231 67 48 25.4 29.0 18.2 20.8 
Germany         
Greece 381 269 107 83 28.1 39.8 21.8 30.9 
Hungary 28 28 10 35.7 35.7 32.1 32.1 
Iceland 22.2 25.0 22.2 25.0 
Ireland (Rep.)     
Italy         
Latvia 50.0 50.0 0.0 0.0 
Lithuania     
Macedonia     
Norway     
Poland 104 100 33 17 31.7 33.0 16.3 17.0 
Portugal 24 21 12 50.0 57.1 33.3 38.1 
Russia C.I.S. 944 910 322 205 34.1 35.4 21.7 22.5 
Serbia/Montenegro 0.0 0.0 0.0 0.0 
Slovenia 19 17 15.8 17.6 10.5 11.8 
Spain 4801 4219 2190 1151 45.6 51.9 24.0 27.3 
Sweden 73 97 28 20 38.4 28.9 27.4 20.6 
Switzerland         
The Netherlands         
Turkey     
Ukraine 59 57 27 23 45.8 47.4 39.0 40.4 
UK 2150 1959 582 502 27.1 29.7 23.3 25.6 
All 10 334 9296 3707 2312 35.6 39.6   

The recording of deliveries is incomplete. For Greece in 2 pregnancies, no further data were available. For Russia in 56 pregnancies, no further data were available.

Note that the recording of deliveries is incomplete due to loss of follow-up in several countries.

Table VI shows that after IVF, 27 845 pregnancies resulted from 104 739 aspirations and 92 355 embryo transfers. Thus, the mean clinical pregnancy rate was 26.6% per aspiration and 30.1% per embryo transfer.

Table VII shows that after ICSI, 42 040 pregnancies resulted from 154 857 aspirations and 141 276 transfers. Thus, the mean clinical pregnancy rate was 27.1% per aspiration and 29.8% per embryo transfer.

Table VIII shows that after FER, 12 275 pregnancies resulted from 64 147 transfers. Thus, the mean clinical pregnancy rate per embryo transfer after FER was 19.1%.

Table IX shows that after ED, 3707 clinical pregnancies resulted from 9296 embryo transfers, giving a clinical pregnancy rate per transfer of 39.8%.

In Tables VI, VII, VIII and IX, the delivery rates per embryo transfer have not been summarized due to incomplete or absence of follow-up of pregnancies in many countries.

Preimplantation genetic diagnosis/screening

PGD/PGS activity was recorded from 12 countries, as indicated in Table I: totally it involved two thousand seven hundred and one cycles, 1691 aspirations, 1849 embryo transfers, 789 pregnancies (42.7% per transfer) and 331 deliveries.

In vitro maturation

IVM was recorded in five countries: Finland (96 cycles), Poland (2 cycles), Russia (34 cycles), Serbia and Montenegro (4 cycles) and Slovenia (34 cycles). The 170 cycles resulted in 17 (10%) pregnancies.

Singleton, twin, triplet and quadruplet deliveries

Table X shows the deliveries after IVF and ICSI in relation to singleton, twin and triplet deliveries. The distribution of the deliveries was: singleton 34 846 (77.2%), twin 9 790 (21.7%) and triplet 438 (1.0%).

Table X.

Singleton, twin, triplet and quadruplet deliveries after IVF and ICSI in 2004.

Country All deliveries Clinical pregnancies Documented pregnancy loss Lost to follow-up Singleton deliveries Twin deliveries Triplet deliveries 
Albania 10 25 15 70.0 30.0 0.0 
Austria 233 1349   165 70.8 65 27.9 1.3 
Belgium 1802 2814   1614 89.6 184 10.2 0.2 
Bulgaria 210 256 36 149 71.0 54 25.7 3.3 
Denmark 1980 2563 338 245 1557 78.6 416 21.0 0.4 
Finland 886 1133 245 768 86.7 114 12.9 0.5 
Francea 8961 11 696 2735 36a 6911 77.1 1966 21.9 48 0.5 
Germany 6699 10 252 2422 1131 5239 78.2 1386 20.7 74 1.1 
Greece 1234 2526 280 1012 837 67.8 378 30.6 19 1.5 
Hungary 604 795 160 31 386 63.9 199 32.9 19 3.1 
Iceland 53 63 10 41 77.4 10 18.9 3.8 
Ireland (Rep.) 393 509 110 302 76.8 89 22.6 0.5 
Italy 3006 4826 945 875 2305 76.7 640 21.3 61 2.0 
Latvia 22 34 16 72.7 27.3 0.0 
Lithuania 10 21 60.0 30.0 10.0 
Macedonia 59 84 24 42 71.2 15 25.4 3.4 
Norway 1100 1358 246 25 828 75.3 255 23.2 0.3 
Poland 842 1187 142 203 650 77.2 181 21.5 11 1.3 
Portugal 477 651 142 32 358 75.1 113 23.7 1.3 
Russia C.I.S. 2109 3698 603 986 1542 73.1 525 24.9 42 2.0 
Serbia/Montenegro           
Slovenia 444 553 100 13 360 81.1 77 17.3 0.7 
Spain 3818 7866 1283 2765 2790 73.1 959 25.1 69 1.8 
Sweden 2027 2566 526  1912 94.3 114 5.6 0.0 
Switzerland 528 732 155 49 410 77.7 112 21.2 1.1 
The Netherlands           
Turkey 570 1337 166 602 346 60.7 207 36.3 17 3.0 
Ukraine 304 375 69 193 63.5 106 34.9 1.6 
UK 6747 7633 779 107 5112 75.8 1613 23.9 22 0.3 
All 45 128 66 902   34 846 77.2 9790 21.7 438 1.0 
Country All deliveries Clinical pregnancies Documented pregnancy loss Lost to follow-up Singleton deliveries Twin deliveries Triplet deliveries 
Albania 10 25 15 70.0 30.0 0.0 
Austria 233 1349   165 70.8 65 27.9 1.3 
Belgium 1802 2814   1614 89.6 184 10.2 0.2 
Bulgaria 210 256 36 149 71.0 54 25.7 3.3 
Denmark 1980 2563 338 245 1557 78.6 416 21.0 0.4 
Finland 886 1133 245 768 86.7 114 12.9 0.5 
Francea 8961 11 696 2735 36a 6911 77.1 1966 21.9 48 0.5 
Germany 6699 10 252 2422 1131 5239 78.2 1386 20.7 74 1.1 
Greece 1234 2526 280 1012 837 67.8 378 30.6 19 1.5 
Hungary 604 795 160 31 386 63.9 199 32.9 19 3.1 
Iceland 53 63 10 41 77.4 10 18.9 3.8 
Ireland (Rep.) 393 509 110 302 76.8 89 22.6 0.5 
Italy 3006 4826 945 875 2305 76.7 640 21.3 61 2.0 
Latvia 22 34 16 72.7 27.3 0.0 
Lithuania 10 21 60.0 30.0 10.0 
Macedonia 59 84 24 42 71.2 15 25.4 3.4 
Norway 1100 1358 246 25 828 75.3 255 23.2 0.3 
Poland 842 1187 142 203 650 77.2 181 21.5 11 1.3 
Portugal 477 651 142 32 358 75.1 113 23.7 1.3 
Russia C.I.S. 2109 3698 603 986 1542 73.1 525 24.9 42 2.0 
Serbia/Montenegro           
Slovenia 444 553 100 13 360 81.1 77 17.3 0.7 
Spain 3818 7866 1283 2765 2790 73.1 959 25.1 69 1.8 
Sweden 2027 2566 526  1912 94.3 114 5.6 0.0 
Switzerland 528 732 155 49 410 77.7 112 21.2 1.1 
The Netherlands           
Turkey 570 1337 166 602 346 60.7 207 36.3 17 3.0 
Ukraine 304 375 69 193 63.5 106 34.9 1.6 
UK 6747 7633 779 107 5112 75.8 1613 23.9 22 0.3 
All 45 128 66 902   34 846 77.2 9790 21.7 438 1.0 

A total of three quadruplet deliveries were recorded. These were not included in the table or in the total number of deliveries. Deliveries refer to those deliveries with documented number of infants. For Austria and Belgium, no numbers on pregnancy loss and loss for follow-up were reported. No data are available for Serbia and Montenegro and The Netherlands.

aFrance: for all 'lost to follow up' cases there was delivery, but no details could be reported.

Table XI shows deliveries after FER in relation to singleton, twin and triplet deliveries. It is seen that the distribution of the deliveries was: singleton 6625 (84.8%), twin 1142 (14.6%) and triplet 36 (0.5%).

Table XI.

Singleton, twin, triplet and quadruplet deliveries after FER in 2004.

Country All deliveries Clinical pregnancies Documented pregnancy loss Lost to follow-up Singleton deliveries Twin deliveries Triplet deliveries 
Albania           
Austria           
Belgium 394 510   336 85.3 57 14.5 0.3 
Bulgaria 75.0 25.0 0.0 
Denmark 158 256 60 38 127 80.4 29 18.4 1.3 
Finland 518 715 191 463 89.4 54 10.4 0.2 
Francea 1424 1983 559 10a 1212 85.1 197 13.8 0.4 
Germany 1759 2947 818 370 1494 84.9 252 14.3 13 0.7 
Greece 182 334 45 107 147 80.8 34 18.7 0.5 
Hungary 58 78 20 44 75.9 14 24.1 0.0 
Iceland 17 77.8 22.2 0.0 
Ireland (Rep.) 71 105 29 60 84.5 11 15.5 0.0 
Italy 260 407 98 49 226 86.9 32 12.3 0.8 
Latvia 100.0 0.0 0.0 
Lithuania    
Macedonia         
Norway 124 164 40 97 78.2 26 21.0 0.8 
Poland 111 209 44 54 98 88.3 12 10.8 0.9 
Portugal 29 58 20 19 65.5 10 34.5 0.0 
Russia C.I.S. 194 337 72 71 157 80.9 36 18.6 0.5 
Serbia/Montenegro           
Slovenia 76 92 14 70 92.1 7.9 0.0 
Spain 537 1229 291 401 430 80.1 101 18.8 1.1 
Sweden 498 686 187  450 90.4 47 9.4 0.2 
Switzerland 317 446 105 24 269 84.9 48 15.1 0.0 
The Netherlands           
Turkey 0.0 100.0 0.0 
Ukraine 11 11 11 100.0 0.0 0.0 
UK 1072 1244 146 26 900 84.0 171 16.0 0.1 
All 7813 11 851   6625 84.8 1142 14.6 36 0.5 
Country All deliveries Clinical pregnancies Documented pregnancy loss Lost to follow-up Singleton deliveries Twin deliveries Triplet deliveries 
Albania           
Austria           
Belgium 394 510   336 85.3 57 14.5 0.3 
Bulgaria 75.0 25.0 0.0 
Denmark 158 256 60 38 127 80.4 29 18.4 1.3 
Finland 518 715 191 463 89.4 54 10.4 0.2 
Francea 1424 1983 559 10a 1212 85.1 197 13.8 0.4 
Germany 1759 2947 818 370 1494 84.9 252 14.3 13 0.7 
Greece 182 334 45 107 147 80.8 34 18.7 0.5 
Hungary 58 78 20 44 75.9 14 24.1 0.0 
Iceland 17 77.8 22.2 0.0 
Ireland (Rep.) 71 105 29 60 84.5 11 15.5 0.0 
Italy 260 407 98 49 226 86.9 32 12.3 0.8 
Latvia 100.0 0.0 0.0 
Lithuania    
Macedonia         
Norway 124 164 40 97 78.2 26 21.0 0.8 
Poland 111 209 44 54 98 88.3 12 10.8 0.9 
Portugal 29 58 20 19 65.5 10 34.5 0.0 
Russia C.I.S. 194 337 72 71 157 80.9 36 18.6 0.5 
Serbia/Montenegro           
Slovenia 76 92 14 70 92.1 7.9 0.0 
Spain 537 1229 291 401 430 80.1 101 18.8 1.1 
Sweden 498 686 187  450 90.4 47 9.4 0.2 
Switzerland 317 446 105 24 269 84.9 48 15.1 0.0 
The Netherlands           
Turkey 0.0 100.0 0.0 
Ukraine 11 11 11 100.0 0.0 0.0 
UK 1072 1244 146 26 900 84.0 171 16.0 0.1 
All 7813 11 851   6625 84.8 1142 14.6 36 0.5 

Deliveries refer to those deliveries with documented number of infants. For Austria and Belgium no numbers on pregnancy loss and loss for follow up were reported. No data are available for Albania, Austria, Serbia and Montenegro and The Netherlands.

aFrance: for all 'lost to follow up' cases there was delivery, but no details could be reported.

Risks and fetal reductions

Table XII presents the incidence of ovarian hyperstimulation syndrome (OHSS) recorded from registers in 25 of the 29 countries. It is seen that 2858 cases of OHSS were recorded. The number of IVF and ICSI cycles in those 25 countries were 242 472, corresponding to a risk of OHSS of 1.2% of all stimulated cycles. Other complications are seen in the table.

Table XII.

Complications and fetal reductions in 2004.

Country OHSS All complications to oocyte retrieval Bleeding Infection Maternal death Fetal reduction 
Albania 
Austria       
Belgium 175 232 19 27  
Bulgaria 22 
Denmark       
Finland 49 21 13 
France 297 309 10 299 106 
Germany 232 273 271 aNA 
Greece 43 84 
Hungary 29 15 
Iceland 
Ireland (Rep.) 10  
Italy 170 90 87  
Latvia 
Lithuania 
Macedonia 
Norway 53  
Poland 62 10 10 
Portugal 19  
Russia C.I.S. 700 42 40 47 
Serbia and Montenegro     
Slovenia 16 
Spain 276 26 43 83 
Sweden      
Switzerland 11 
The Netherlands       
Turkey 10 77 
Ukraine 29 
UK 631 85  92 
All 2858 1125 520 362 526 
Country OHSS All complications to oocyte retrieval Bleeding Infection Maternal death Fetal reduction 
Albania 
Austria       
Belgium 175 232 19 27  
Bulgaria 22 
Denmark       
Finland 49 21 13 
France 297 309 10 299 106 
Germany 232 273 271 aNA 
Greece 43 84 
Hungary 29 15 
Iceland 
Ireland (Rep.) 10  
Italy 170 90 87  
Latvia 
Lithuania 
Macedonia 
Norway 53  
Poland 62 10 10 
Portugal 19  
Russia C.I.S. 700 42 40 47 
Serbia and Montenegro     
Slovenia 16 
Spain 276 26 43 83 
Sweden      
Switzerland 11 
The Netherlands       
Turkey 10 77 
Ukraine 29 
UK 631 85  92 
All 2858 1125 520 362 526 

aFor 2004 the German data on fetal reductions are uncertain for technical reasons, and therefore not reported. OHSS: ovarian hyperstimulation syndrome.

Table XII also gives data on the number of recorded fetal reductions. In total, 526 fetal reductions were recorded.

Intrauterine inseminations

Table XIII gives data on IUI-H divided in female age groups below 40 years (upper panel) and 40 years or more (lower panel). For France, no stratification for age was available, and the overall results are included in the group below 40 years of age.

Table XIII.

Intrauterine insemination with husband semen in 2004.

Country Cycles Pregnancies Pregnant (%) Singleton Twin Triplet 
Women<40 years          
Albania 28 10.7 100.0 0.0 0.0 
Austria          
Belgium          
Bulgaria 465 69 14.8 65 94.2 5.8 0.0 
Denmark 7774 1173 15.1 936 79.8 149 12.7 28 2.4 
Finland          
France 48 513 5679 11.7 4994 87.9 653 11.5 32 0.6 
Germany          
Greece 969 176 18.2 147 83.5 24 13.6 1.1 
Hungary 1578 204 12.9 176 86.3 26 12.7 1.0 
Iceland          
Ireland (Rep.) 688 88 12.8 65 73.9 10 11.4 2.3 
Italy 9621 1128 11.7 946 83.9 149 13.2 33 2.9 
Latvia 76 7.9 83.3 16.7 0.0 
Lithuania 190 12 6.3 11 91.7 0.0 0.0 
Macedonia 493 33 6.7 29 87.9 9.1 3.0 
Norway 409 46 11.2 32 69.6 8.7 0.0 
Poland 1736 273 15.7 228 83.5 44 16.1 0.4 
Portugal 961 126 13.1 72 57.1 10 7.9 2.4 
Russia C.I.S.          
Serbia and Montenegro 107 12 11.2 12 100.0  0.0  0.0 
Slovenia 465 40 8.6 38 95.0 5.0 0.0 
Spain 18 469 2518 13.6 2173 86.3 298 11.8 41 1.6 
Sweden          
Switzerland          
The Netherlands          
Turkey 332 44 13.3 27 61.4 13 29.5 9.1 
Ukraine 1226 236 19.2 230 97.5 2.5 0.0 
UK          
All 94 100 11 866 12.6 10 189 86.8 1396 11.9 149 1.3 
Women >40 years          
Albania 0.0    
Austria          
Belgium          
Bulgaria 41 4.9 100.0 0.0 
Denmark 390 25 6.4 22 88.0 12.0 
Finland          
France          
Germany          
Greece 128 6.3 100.0 0.0 
Hungary 79 6.3 100.0 0.0 
Iceland          
Ireland (Rep.) 116 6.9 75.0 25.0 
Italy 2246 180 8.0 160 88.9 20 11.1 
Latvia 0.0    
Lithuania     
Macedonia 42 7.1 66.7 33.3 
Norway          
Poland 105 7.6 100.0 0.0 
Portugal 57 8.8 40.0 0.0 
Russia C.I.S.          
Serbia and Montenegro 42 2.4 100.0  0.0  
Slovenia 0.0    
Spain 998 104 10.4 93 89.4 10 9.6 1.0 
Sweden          
Switzerland          
The Netherlands          
Turkey     
Ukraine 32 3.1 100.0 0.0 
UK          
All 4288 350 8.2 310 89.3 36 10.4 0.3 
Country Cycles Pregnancies Pregnant (%) Singleton Twin Triplet 
Women<40 years          
Albania 28 10.7 100.0 0.0 0.0 
Austria          
Belgium          
Bulgaria 465 69 14.8 65 94.2 5.8 0.0 
Denmark 7774 1173 15.1 936 79.8 149 12.7 28 2.4 
Finland          
France 48 513 5679 11.7 4994 87.9 653 11.5 32 0.6 
Germany          
Greece 969 176 18.2 147 83.5 24 13.6 1.1 
Hungary 1578 204 12.9 176 86.3 26 12.7 1.0 
Iceland          
Ireland (Rep.) 688 88 12.8 65 73.9 10 11.4 2.3 
Italy 9621 1128 11.7 946 83.9 149 13.2 33 2.9 
Latvia 76 7.9 83.3 16.7 0.0 
Lithuania 190 12 6.3 11 91.7 0.0 0.0 
Macedonia 493 33 6.7 29 87.9 9.1 3.0 
Norway 409 46 11.2 32 69.6 8.7 0.0 
Poland 1736 273 15.7 228 83.5 44 16.1 0.4 
Portugal 961 126 13.1 72 57.1 10 7.9 2.4 
Russia C.I.S.          
Serbia and Montenegro 107 12 11.2 12 100.0  0.0  0.0 
Slovenia 465 40 8.6 38 95.0 5.0 0.0 
Spain 18 469 2518 13.6 2173 86.3 298 11.8 41 1.6 
Sweden          
Switzerland          
The Netherlands          
Turkey 332 44 13.3 27 61.4 13 29.5 9.1 
Ukraine 1226 236 19.2 230 97.5 2.5 0.0 
UK          
All 94 100 11 866 12.6 10 189 86.8 1396 11.9 149 1.3 
Women >40 years          
Albania 0.0    
Austria          
Belgium          
Bulgaria 41 4.9 100.0 0.0 
Denmark 390 25 6.4 22 88.0 12.0 
Finland          
France          
Germany          
Greece 128 6.3 100.0 0.0 
Hungary 79 6.3 100.0 0.0 
Iceland          
Ireland (Rep.) 116 6.9 75.0 25.0 
Italy 2246 180 8.0 160 88.9 20 11.1 
Latvia 0.0    
Lithuania     
Macedonia 42 7.1 66.7 33.3 
Norway          
Poland 105 7.6 100.0 0.0 
Portugal 57 8.8 40.0 0.0 
Russia C.I.S.          
Serbia and Montenegro 42 2.4 100.0  0.0  
Slovenia 0.0    
Spain 998 104 10.4 93 89.4 10 9.6 1.0 
Sweden          
Switzerland          
The Netherlands          
Turkey     
Ukraine 32 3.1 100.0 0.0 
UK          
All 4288 350 8.2 310 89.3 36 10.4 0.3 

For France all treatments are classified as being in women <40 years, because of lack of age stratification. Distribution of singleton versus multiple gestations is based on deliveries.

In women below 40 years of age, 94 100 treatments resulted in 11 866 pregnancies giving a pregnancy rate per procedure of 12.6%. In women at 40 years or above, the corresponding figures were 4288%, 350% and 8.2%.

In women below 40, singleton, twin and triplet pregnancies accounted for 86.6%, 11.9% and 1.3% of the pregnancies, respectively, whereas in women above 40 the corresponding figures were 89.3%, 10.4% and 0.3%.

Table XIV gives data on IUI-D divided in female age groups below 40 years (upper panel) and 40 years or more (lower panel). For France, no stratification for age was available, and the overall results are included in the group below 40 years of age.

Table XIV.

Intrauterine insemination with donor semen in 2004.

Country Cycles Pregnancies Pregnant (%) Singleton Twin Triplet 
Women <40 years          
Albania     
Austria          
Belgium          
Bulgaria 231 31 13.4 28 90.3 9.7 0.0 
Denmark 1433 257 17.9 223 86.8 32 12.5 0.8 
Finland          
France 3349 621 18.5 534 86.0 85 13.7 0.3 
Germany          
Greece 171 46 26.9 37 80.4 19.6 0.0 
Hungary 116 27 23.3 22 81.5 18.5 0.0 
Iceland          
Ireland (Rep.) 130 30 23.1 24 80.0 6.7 0.0 
Italy          
Latvia 76 10 13.2 80.0 20.0 0.0 
Lithuania     
Macedonia         
Norway 457 80 17.5 58 72.5 10 12.5 0.0 
Poland 434 90 20.7 78 86.7 12 13.3 0.0 
Portugal 194 46 23.7 28 60.9 8.7 0.0 
Russia C.I.S.          
Serbia and Montenegro          
Slovenia 18 22.2 50.0 25.0 0.0 
Spain 4292 928 21.6 795 85.7 117 12.6 14 1.5 
Sweden 371 82 22.1 55 67.1 8.5 0.0 
Switzerland          
The Netherlands          
Turkey     
Ukraine 330 96 29.1 94 97.9 2.1 0.0 
UK 4280 617 14.4 572 92.7 33 5.3 1.0 
All 15 882 2965 18.7 2558 88.0 324 11.1 24 0.8 
Women >40 years          
Albania     
Austria          
Belgium          
Bulgaria 16.7 100.0 0.0 
Denmark 143 10 7.0 10 100.0 0.0 
Finland          
France          
Germany          
Greece 26 30.8 75.0 0.0 
Hungary 0.0    
Iceland          
Ireland (Rep.) 18 5.6 0.0 0.0 
Italy          
Latvia     
Lithuania     
Macedonia     
Norway          
Poland 35 11.4 100.0 0.0 
Portugal 50.0 0.0 0.0 
Russia C.I.S.          
Serbia and Montenegro          
Slovenia          
Spain 570 70 12.3 63 90.0 7.1 2.9 
Sweden 23  0.0    
Switzerland          
The Netherlands          
Turkey     
Ukraine 0.0    
UK 881 48 5.4 43 89.6 10.4 
All 1710 143 8.4 128 91.4 10 7.1 1.4 
Country Cycles Pregnancies Pregnant (%) Singleton Twin Triplet 
Women <40 years          
Albania     
Austria          
Belgium          
Bulgaria 231 31 13.4 28 90.3 9.7 0.0 
Denmark 1433 257 17.9 223 86.8 32 12.5 0.8 
Finland          
France 3349 621 18.5 534 86.0 85 13.7 0.3 
Germany          
Greece 171 46 26.9 37 80.4 19.6 0.0 
Hungary 116 27 23.3 22 81.5 18.5 0.0 
Iceland          
Ireland (Rep.) 130 30 23.1 24 80.0 6.7 0.0 
Italy          
Latvia 76 10 13.2 80.0 20.0 0.0 
Lithuania     
Macedonia         
Norway 457 80 17.5 58 72.5 10 12.5 0.0 
Poland 434 90 20.7 78 86.7 12 13.3 0.0 
Portugal 194 46 23.7 28 60.9 8.7 0.0 
Russia C.I.S.          
Serbia and Montenegro          
Slovenia 18 22.2 50.0 25.0 0.0 
Spain 4292 928 21.6 795 85.7 117 12.6 14 1.5 
Sweden 371 82 22.1 55 67.1 8.5 0.0 
Switzerland          
The Netherlands          
Turkey     
Ukraine 330 96 29.1 94 97.9 2.1 0.0 
UK 4280 617 14.4 572 92.7 33 5.3 1.0 
All 15 882 2965 18.7 2558 88.0 324 11.1 24 0.8 
Women >40 years          
Albania     
Austria          
Belgium          
Bulgaria 16.7 100.0 0.0 
Denmark 143 10 7.0 10 100.0 0.0 
Finland          
France          
Germany          
Greece 26 30.8 75.0 0.0 
Hungary 0.0    
Iceland          
Ireland (Rep.) 18 5.6 0.0 0.0 
Italy          
Latvia     
Lithuania     
Macedonia     
Norway          
Poland 35 11.4 100.0 0.0 
Portugal 50.0 0.0 0.0 
Russia C.I.S.          
Serbia and Montenegro          
Slovenia          
Spain 570 70 12.3 63 90.0 7.1 2.9 
Sweden 23  0.0    
Switzerland          
The Netherlands          
Turkey     
Ukraine 0.0    
UK 881 48 5.4 43 89.6 10.4 
All 1710 143 8.4 128 91.4 10 7.1 1.4 

For France all treatments are classified as being in women <40 years, because of lack of age stratification. Distribution of singleton versus multiple gestations is based on deliveries.

In women below 40 years of age, 15 882 treatments resulted in 2965 pregnancies giving a pregnancy rate per insemination of 18.7%. In women at 40 years or above, the corresponding figures were 1710%, 143% and 8.4%.

In women below 40, singleton, twin and triplet pregnancies accounted for 88.0%, 11.1% and 0.8% of the pregnancies, respectively, whereas in women above 40, the corresponding figures were 91.4%, 7.1% and 1.4%.

Cumulative delivery rates

Table XV gives an estimation of the cumulative delivery rates per initiated fresh stimulated cycle. This is not the real cumulative delivery rate per couple, but shows the number of deliveries obtained from the FER cycles added to the deliveries from the stimulated cycles during the same year. Additionally, the table shows the rate of multiple deliveries after FER and stimulated cycles combined.

Table XV.

The cumulative delivery rates in fresh and frozen cycles in 2004.

Country Cycles IVF and ICSI Deliveries fresh cycles Multiple deliveries fresh cycles Thawings FER Deliveries FER Multiple deliveries FER Deliveries fresh cycles per initiated cycle (%) Deliveries fresh and FER per initiated cycle (%) Multiple deliveries Fresh and FER per total delivery (%) 
Albania 123 10 8.1 8.1 30.0 
Austria 4504 233 68    5.2   
Belgium 13 794 1802 188 4802 394 58 13.1 15.9 11.2 
Bulgaria 928 210 62 53 22.6 23.1 29.4 
Denmark 9598 1980 423 1853 158 31 20.6 22.3 21.2 
Finland 4761 886 118 3434 518 55 18.6 29.5 12.3 
France 55 217 8961 2014 14 069 1424 202 16.2 18.8 21.3 
Germany 38 824 6699 1460 17 989 1759 265 17.3 21.8 20.4 
Greece 8218 1234 397 1115 182 35 15.0 17.2 30.5 
Hungary 2593 604 218 256 58 14 23.3 25.5 35.0 
Iceland 234 53 12 73 22.6 26.5 22.6 
Ireland (Rep.) 2114 410 92 466 71 11 19.4 22.8 21.4 
Italy 23 711 3006 701 2388 260 34 12.7 13.8 22.5 
Latvia 138 22 44 15.9 19.6 22.2 
Lithuania 83 10    12.0   
Macedonia 521 59 17   11.3   
Norway 5136 1100 259 942 124 27 21.4 23.8 23.4 
Poland 3675 842 192 1278 111 13 22.9 25.9 21.5 
Portugal 2491 477 119 368 29 10 19.1 20.3 25.5 
Russia C.I.S. 12 052 2109 567 1755 194 37 17.5 19.1 26.2 
Serbia and Montenegro 181         
Slovenia 2100 444 80 567 76 21.1 24.8 16.5 
Spain 27 481 3818 1028 7312 537 107 13.9 15.8 26.1 
Sweden 9593 2027 115 3205 498 48 21.1 26.3 6.5 
Switzerland 3145 528 118 2573 317 48 16.8 26.9 19.6 
The Netherlands 15 297         
Turkey 3472 570 224 67 16.4 16.5 39.5 
Ukraine 1505 304 111 38 11 20.2 20.9 35.2 
UK 30 375 6747 1635 7349 1072 172 22.2 25.7 23.1 
All 281 864 45 145 10 231  7813 1178 16.0 18.8 21.5 
Country Cycles IVF and ICSI Deliveries fresh cycles Multiple deliveries fresh cycles Thawings FER Deliveries FER Multiple deliveries FER Deliveries fresh cycles per initiated cycle (%) Deliveries fresh and FER per initiated cycle (%) Multiple deliveries Fresh and FER per total delivery (%) 
Albania 123 10 8.1 8.1 30.0 
Austria 4504 233 68    5.2   
Belgium 13 794 1802 188 4802 394 58 13.1 15.9 11.2 
Bulgaria 928 210 62 53 22.6 23.1 29.4 
Denmark 9598 1980 423 1853 158 31 20.6 22.3 21.2 
Finland 4761 886 118 3434 518 55 18.6 29.5 12.3 
France 55 217 8961 2014 14 069 1424 202 16.2 18.8 21.3 
Germany 38 824 6699 1460 17 989 1759 265 17.3 21.8 20.4 
Greece 8218 1234 397 1115 182 35 15.0 17.2 30.5 
Hungary 2593 604 218 256 58 14 23.3 25.5 35.0 
Iceland 234 53 12 73 22.6 26.5 22.6 
Ireland (Rep.) 2114 410 92 466 71 11 19.4 22.8 21.4 
Italy 23 711 3006 701 2388 260 34 12.7 13.8 22.5 
Latvia 138 22 44 15.9 19.6 22.2 
Lithuania 83 10    12.0   
Macedonia 521 59 17   11.3   
Norway 5136 1100 259 942 124 27 21.4 23.8 23.4 
Poland 3675 842 192 1278 111 13 22.9 25.9 21.5 
Portugal 2491 477 119 368 29 10 19.1 20.3 25.5 
Russia C.I.S. 12 052 2109 567 1755 194 37 17.5 19.1 26.2 
Serbia and Montenegro 181         
Slovenia 2100 444 80 567 76 21.1 24.8 16.5 
Spain 27 481 3818 1028 7312 537 107 13.9 15.8 26.1 
Sweden 9593 2027 115 3205 498 48 21.1 26.3 6.5 
Switzerland 3145 528 118 2573 317 48 16.8 26.9 19.6 
The Netherlands 15 297         
Turkey 3472 570 224 67 16.4 16.5 39.5 
Ukraine 1505 304 111 38 11 20.2 20.9 35.2 
UK 30 375 6747 1635 7349 1072 172 22.2 25.7 23.1 
All 281 864 45 145 10 231  7813 1178 16.0 18.8 21.5 

For Austria, Belgium, Germany, Iceland, Lithuania and Portugal 'fresh cycles' for IVF and ICSI refer to aspirations.

Note that the recording of deliveries is incomplete due to loss of follow-up in several countries.

Comments

The present report is the eighth consecutive, annual European report on ART data. Together, these reports cover treatment cycles from 1997 to 2004. It can be argued that as long as data are incomplete, generated through different methods of data collection and still using partly different definitions, the data should not be summarized, as it occurs in this report. Therefore, the focus should primarily be on specific country data rather than on summary data.

In 2004, the number of countries reporting to ESHRE’s EIM Consortium increased to 29 countries covering the whole of Western Europe. In Eastern and South Eastern Europe, no data were available from countries such as Bosnia, Croatia, the Czech Republic, Romania and Slovakia.

Compared with 2003, the number of cycles in Germany showed a dramatic fall from 102 426 to only 56 813. This occurred following a more restrictive re-imbursement policy, introduced in January 2004, providing strong evidence that the re-imbursement policy for ART has a major impact on the accessibility and use of these treatments. Data from the German register (www.deutsches-ivf-register.de) include 2005, and show that this decline was not reversible, as the number of ART treatments remained much lower in 2005 than in 2002 and 2003.

Despite the declining activity in Germany, the number of reported cycles reached 367 066 in 2004, marginally more than the 365 103 cycles recorded in 2003. Additionally, the present report includes 116 000 IUI cycles.

Within Europe, the largest number of cycles from a single country were reported from France (70 000), Germany (57 000), Spain (41 000) and the UK (40 000). In comparison, the American Society for Reproductive Medicine/Society for Assisted Reproductive Technology registry reported close to 128 000 cycles from the USA in 2004 (Wright et al., 2007).

We still do not have a complete European set of data, as the present report only includes around 70% of all centres in the reporting countries. However, we believe that those clinics that do not report are likely to be smaller in size than those that do report. In southern Europe, a number of countries still in 2004 had a low coverage among the clinics (Greece 33%; Spain 46% and Italy 61%). In Italy, reporting became mandatory in 2004, but this was not fully implemented. In Greece, a statutory IVF register is going to be established, and the number of reporting clinics from Spain is growing.

The average number of treatment cycles per million inhabitants was 1095 with a range from 80 in Latvia to 2128 in Denmark (Table II). Another way to define the availability of ART is that four treatment cycles were done per 1000 women of reproductive age (15–49 years).

The proportion of ICSI versus standard IVF procedures continues to increase (49% in 2001; 52% in 2002; 55% in 2003 and 59% in 2004). A similar increase has been observed in the USA where the percentage of ICSI cycles reached 57.5% in 2004 (Jain and Gupta, 2007). Interestingly, the percentage of diagnosis of infertility attributed to male-factor conditions remained stable in the USA, but a high use of ICSI was related to states with insurance coverage. Also in Europe, there is a marked variation between countries. The possible explanations for the increased use of ICSI and the variability between countries should be further analysed.

The number of embryos transferred in IVF and ICSI cycles differed substantially between countries, also in this report, but there is a clear trend during the years of observation towards transfers with fewer embryos. The mean percentage of SETs increased from 12.0% in 2001 to 13.7% in 2002, to 15.7% in 2003 and to 19.1% in 2004. The proportion of DETs has been stable during the last 3 years, but the proportion of three (22.1%) and four (3.3%) embryo transfers continued to decrease in 2004. In conclusion, the reduction in the number of embryos transferred continued in 2004.

This report is unable to define the number of elective SET (eSET) versus SET, but the rise in the number of transfers of one embryo is undoubtedly due to a rise in eSET. As seen in Table V, there were six countries that reported transfer of a single embryo in more than 25% of all transfers. The highest rates were in Finland (47%), Belgium (49%) and Sweden (67%).

The consistent trend towards transfer of fewer embryos is also reflected in the overall occurrence of multiple deliveries after IVF and ICSI. In 2000, the average multiple delivery rate was 26.9%, declining to 25.5% in 2001, to 24.5% in 2002, to 23.1% in 2003 and to 22.7% in 2004. During the 8 year period of EIM reporting the most remarkable finding regarding multiples has been the reduction in triplet deliveries from 3.6% in 1997, to 2.3% in 1998, 2.3% in 1999, 1.9% in 2000, 1.5% in 2001, 1.3% in 2002, 1.1% in 2003 and 1.0% in 2004. Still, however, huge differences in triplet rates exist between countries.

When analysing the range of multiple delivery rates in different countries, the number of fetal reductions should also be considered. A total of 526 procedures were reported, the largest numbers coming from France (106), the UK (92), Greece (84) and Spain (83). For 2004, the German data were not available. Without this intervention, the proportion of triplet deliveries would certainly have been higher, considering that a number of countries did not report on fetal reductions, and the fact that the number reported is higher than the number of recorded triplet deliveries that was 438 after IVF/ICSI and 36 after FER.

Pregnancy rates for IVF, ICSI and FER were marginally increased compared with 2003. For IVF, the mean pregnancy rate per transfer was 30.1% compared with 29.6% in 2003. For ICSI, the mean pregnancy rate was 29.8% compared with 28.7% in 2003. For FER, it was 19.1% compared with 18.6% in 2003. The figures from Europe remain lower than in the USA where 41.5% (fresh embryos) and 35.1% (FER transfers) of ART transfers resulted in a pregnancy (Wright et al., 2007). However, the multiple birth rates in the USA were also considerably higher at 34% after fresh transfers and 28% after FER transfers.

With a noticeable decline in the number of embryos transferred, the cumulative delivery rate per started cycle may be a most relevant end-point for ART. Table XV gives a calculation of cumulative delivery rates, but it should be stressed that this does not represent the true cumulative delivery rate per cycle and per couple, but only gives an estimation based on fresh and FER cycles done during the same year. In a steady-state situation, this calculation will give a rather good estimate of the true cumulative delivery rate. An example of expressing outcomes in this manner is data from Finland where the delivery rate per fresh cycle was 18.6%, the cumulative delivery rate after frozen replacement of embryos reached 29.5%, with an overall multiple delivery rate of 12.3%. For Sweden, the delivery rate increased from 21.1% to 26.3% per started cycle, with only 6.5% multiple deliveries. In the UK, the corresponding rates for live births were 22.2% and 25.7%, and the multiple delivery rates were 23.1%. In conclusion, the FER cycles add a considerable number of deliveries in some countries.

PGD/PGS activity was recorded from 12 countries, as indicated in Table I: totally it involved 2051 cycles, 1691 aspirations, 1849 embryo transfers, 789 pregnancies (42.7% per transfer) and 331 deliveries.

Altogether, 2051 cycles with PGD/PGS were reported, compared with 1956 in 2003. ESHRE has a specially focused and more comprehensive reporting on PGD by the sixth ESHRE PGD Consortium report, which included a total of 2984 cycles in 2003. The two reporting systems are different, as the PGD Consortium bases their reports on detailed data from individual clinics. A comparison indicates that the number of PGD cycles reported to the National registers, only include around two thirds of the total activity (Sermon et al., 2007).

Regarding direct risks of ART, OHSS was recorded in 1.2% of cycles, and during 2004 a total of four maternal deaths were recorded. We do not have data regarding the causes of these tragic events.

For the third consecutive year, the present report includes European data on treatments with IUI-H (98 388 cycles) and IUI-D (17 592 cycles). The coverage of IUI activities by the national registers is much less comprehensive than for the in vitro techniques. In women below 40 years of age, the pregnancy rate was 12.6% for IUI-H and 18.7% for IUI-D. In women at 40 years or above, the corresponding figures were 8.2% and 8.4%.

After IUI-H in women below 40 years of age, twin pregnancies occurred in 11.9% and triplet pregnancies in 1.3%. The data suggest that the twinning rates are only half of what is found with the in vitro techniques, but triplet rates are marginally higher.

In summary, the present eighth ESHRE report on ART for Europe in 2004 shows a continuing expansion of numbers of participating clinics, countries and treatment cycles reported. Pregnancy rates after IVF, ICSI and FER were all marginally increased compared with 2003, but fewer embryos were transferred and multiple delivery rates continued to decline accounting for 21.7% of all deliveries after IVF and ICSI. eSET had a considerable impact in Belgium, Finland and Sweden and several other countries transferred a single embryo in more than 25% of cycles. This transfer policy is now documented, on a national basis, to reduce multiple delivery rates after transfer of fresh embryos. The multiple delivery rates after IVF and ICSI were 5.6% in Sweden, 10.4% in Belgium and 13.3% in Finland. Twin gestations seem to be much less frequent after IUI-H and IUI-D compared with IVF and ICSI.

Supplementary Data

Supplementary data, listing all clinics providing data, are available at http://humrep.oxfordjournals.org/.

Appendix

EIM Committee: Chairman, A. Nyboe Andersen; Chairman elect, J. de Mouzon; Past chairman K. G. Nygren; members, S. Bhattacharya, R. Felberbaum, A. P. Ferraretti. V. Goossens is scientific officer at ESHRE Central Office, Brussels. See below for contact persons representing the data collection programmes in the participating European countries and Supplementary data for contributing centres. Contact persons representing data collection programmes in participating European countries, 2004.

Albania

Prof. Orion Glozheni, University Hospital for Obsterics and Gynecology. Bul. B. Curri, Tirana, Albania. Tel.: +355 4 235 870; fax: +355 4 257 688; mobile: +355 68 20 29 313; e-mail: gliorion@icc-al.org.

Austria

Prof. Dr Heinz Strohmer, Kinderwunschzentrum Private Hospital Goldenes Kreuz, Lazarettg. 16–18, 1090 Wien, Austria. Tel.: +43 1 40 111 1400; fax: +43 1 40 111 1401; e-mail: heinz.strohmer@kinderwunschzentrum.at.

Belgium

Dr Michel Candeur—ULB, Politiques et systèmes de santé, 808, Route de Lennik, 1070 Brussels, Belgium. Tel.: +32 (0)2 555 40 90; mobile: +32 (0) 475 73 78 26; fax: +32 (0)2 555 40 49; e-mail: michel.candeur@ulb.ac.be.

Bulgaria

Prof. Stanimir Kyurkchiev, Inst. Biology & Immunology of Reproduction, Molecular Immunology, 73, Tzaritgradsko shosse, 1113 Sofia, Bulgaria. Tel.: +359 (2) 723 890; fax: +359 (2) 720 925; e-mail: skyurchiev@mail.bg.

Denmark

Dr Karin Erb, Fertility Clinic, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark. Tel.: +45 65 41 23 24; fax: +45 65 90 69 82; e-mail: karin.erb@ouh.regionsyddanmark.dk.

Finland

Dr Aila Tiitinen, Helsinki University Central Hospital, Dept. of Ob/Gyn, PO Box 140, 00029 HUS-Helsinki, Finland. Tel.: +385 50 427 1217; fax: +385 9 4717 4801; e-mail: aila.tiitinen@hus.fi.

Dr Mika Gissler, STAKES National Reserach and Development Centre for Welfare and Health. Information Division, PO Box 220, 00531 Helsinki, Finland. Tel.: +385 9 3967 2279; fax: +385 9 3967 2485; e-mail: mika.gissler@stakes.fi.

France

Dr Jacques De Mouzon, INSERM U U569, 82, Rue Général Leclerc, 94276 Le Kremlin-Bicêtre Cedex, France. Tel.: +33 1 4521 2338; mobile: +33 6 62 06 22 74; fax: +33 1 4521 2075; e-mail: demouzon@vjf.inserm.fr.

Dr Ylana Chalem, Agence de la Biomédecine, 1 Av du stade de France. Tel.: +33 1 55 93 69 24; e-mail: ylana.chalem@biomedecine.fr.

Germany

Prof. Dr Ricardo Felberbaum, Klinikum Kempten Oberallgäu gGmbH, Dept. of OB/Gyn, Robert weixler Strasse 50, 87439 Kempten, Germany. Tel.: +49 831 530 3393; fax: +49 831 530 3457; e-mail: ricardo.felberbaum@klinikum-kempten.de.

Greece

Prof. Dr Basil Tarlatzis, Geniki Kliniki, Infertility and IVF Centre, 2 Gravias Street, 54645 Thessaloniki, Greece. Tel.: +30 231 08 66 477 and 08 21 681; mobile: +30 694 431 53 45; fax: +30 231 08 21 420; e-mail: tarlatzis@hol.gr.

Hungary

Prof. Dr Janos Urbancsek, Semmelweis University, 1st Dept. of Ob/Gyn, Baross utca 27, 1088 Budapest, Hungary. Tel.: +36 1 266 01 15; fax: +36 1 266 01 15; e-mail: urbjan@noi1.sote.hu.

Iceland

Mr H. Bjorgvinsson, Art Medica, IVF Unit, Baejarlind 12, 201 Kopavogur, Iceland. Tel.: +354 560 11 55; fax: +354 560 14 82; e-mail: hilmar@artmedica.is.

Ireland

Dr Edgar Mocanu, HARI Unit, Rotunda Hospital, Dublin 1, Ireland. Tel.: +35 31 8072 732; fax: +35 31 8727 831; e-mail: emocanu@rcsi.ie.

Italy

Dr Guilia Scaravelli, Registro Nazionale della Procreazione Medicalmente Assistita, CNESPS, Instituto Superiore de Sanita, Viale Regina Elena, 299, 00161 Roma. Tel.: +39 49904317; fax: +39 49904324; e-mail: guilia.scaravelli@iss.it.

Latvia

Dr Voldemars Lejins, EGV Clinic, Dept. of IVF, Gertrudes Str. 3, LV 1010 Riga. Tel.: +371 7 27 81 83; fax: +371 7 31 64 67; e-mail: egv@apollo.lv.

Lithuania

Dr Zivile Gudleviciene, Fertility Centre, IVF Laboratory, Mairono 25, 01125 Vilnius, Lithuania. Tel.: +37 052614226; fax: +37 052614226; e-mail: zivile.g.udleviciene@gmail.com.

Macedonia

Dr Slobodan Lazarevski, SHOG ‘Mala Bogorodica’, Londonska 19, 1000 Skopje, Macedonia. Tel.: +389 2 30 73 335; mobile: +389 70 246 089; fax: +389 2 30 73 398; e-mail: dr.lazarevski@mbogorodica.com.mk.

The Netherlands

Prof. Dr Jan A.M. Kremer, University Hospital (St Radboud), Dept. of Ob/Gyn, Geert Grooteplein 10, PO Box 9101, 6500 HB Nijmegen, The Netherlands. Tel.: +31 24 361 47 48; fax: +31 24 354 11 94; e-mail: j.kremer@obgyn.umcn.nl.

Norway

Dr Johan T. Hazekamp, Volvat Medisinske Senter, A.S., PO Box 5280 Majorstua, 0303 Oslo, Norway. Tel.: +47 22 95 75 00; fax: +47 22 93 24 02; e-mail: johan.hazekamp@volvat.no.

Poland

Mr Waldemar Kuczynski, Medical Akademy I, Dept. of Ob/Gyn, Sklodowska 24a, 15-276 Bialystok, Poland. Tel.: +48 502 273 923; fax: +48 85 744 13 78; e-mail: kuczynsk@pb.bialystok.pl.

Portugal

Prof. Dr Carlos Calhaz-Jorge, Human Reproduction Unit, Dept of Ob/Gyn, Hosp. de Santa Maria, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal. Tel.: +351 21 72 64 229; fax: +351 21 78 05 621; e-mail: calhazjorge@mail.telepac.pt.

Russia

Dr Vladislav Korsak, International Center for Reproductive Medicine, Head of IVF Centre, Mendeleyevskay Liniya 3, Vasilievsky Island, 199034 St-Petersburg, Russia C.I.S. Tel.: +7 812 328 2251; fax: +7 812 328 22 51; e-mail: korsak@mcrm.ru.

Serbia and Montenegro

Prof. Nebosja Radunovic, Institute for Obstetrics and Gynecology, Visegradska 26, 11000 Belgrade. Tel.: +38 163200204; fax: +38 1113615603; e-mail: radunn01@med.nyu.edu.

Slovenia

Dr Tomaz Tomazevic, University Medical Centre Ljubljana, Obstetrics Ginecology Reproduction, Slajmerjeva 3, 61000 Ljubljana, Slovenia. Tel.: +386 1 522 60 60; fax: +386 1 439 75 90; e-mail: tomaz.tomazevic@guest.arnes.si.

Spain

Dr Juana Hernandez Hernandez, Hospital San Millan, Servicio de Ginecologia y Obstetricia, Avda. Autonoma de la Rioja 3, 26001 Logrono, Spain. Tel.: +34 94 12 94 500; fax: +34 94 12 94 515; e-mail: jhernandezh@telefonica.net.

Sweden

Dr Per-Olof Karlstrom, Akademiska Hospital, Dept. of Ob/Gyn, 751 85 Uppsala, Sweden. Tel.: +46 611 2838; fax: +46 211 31611; e-mail: pok.red@swipnet.se.

Switzerland

Ms Maya Weder, Administration FIVNAT, Postfach 89, 3122 Kehrsatz, Switzerland. Tel.: +41 (0) 31 819 76 02; fax +41 (0) 31 819 89 20; e-mail: administration.sgrm@bluewin.ch.

Turkey

Dr Mete Isikoglu, Ozel Antalya Tup Bebek Merkezi, Antalya IVF Center, Tup Bebek, Halide Edip cad. No: 7, 07080 Antalya, Turkey. Tel.: +90 242 3454700; fax: +90 242 3454700; e-mail: misikoglu@gmail.com.

Ukraine

Dr Viktor Veselovsky, Isida IVF Clinic Gynaecology Dept. Lepse 6, 03126 Kyiv, Ukraine. Tel.: +380 44 25 12 101; fax: +380 44 25 12 108; e-mail: vessel@ihome.net.ua.

UK

Dr Richard Baranowski, Business Analyst, Deputy Information Manager, Human Fertilization and Embryology Authority (HFEA), 21 Bloomsbury Street, London WC1B 3HF, UK. Tel.: +44 (0) 20 7291 8313; fax: +44 (0) 20 7291 8201; e-mail: richard.baranowski@hfea.gov.uk.

References

Directive 2004/23/EC of the European Parliament and the Council of 31th March 2004
On setting standards of quality and safety for the donation, procurement, testing, processing, preservation, storage and distribution of human tissues and cells
Official J Eur Union
 , 
2004
, vol. 
102/48
 (pg. 
1
-
11
)
ESHRE
The European IVF-monitoring programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE). Assisted reproductive technology in Europe, 1997. Results generated from European registers by ESHRE
Hum Reprod
 , 
2001
, vol. 
a 16
 (pg. 
384
-
391
)
ESHRE
The European IVF monitoring programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE). Assisted reproductive technology in Europe, 1998. Results generated from European Registers by ESHRE
Hum Reprod
 , 
2001
, vol. 
b 16
 (pg. 
2459
-
2471
)
ESHRE
The European IVF monitoring programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE). Assisted reproductive technology in Europe, 1999. Results generated from European Registers by ESHRE
Hum Reprod
 , 
2002
, vol. 
17
 (pg. 
3260
-
3274
)
ESHRE
The European IVF monitoring programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE). Assisted reproductive technology in Europe, 2000. Results generated from European Registers by ESHRE
Hum Reprod
 , 
2004
, vol. 
19
 (pg. 
490
-
503
)
ESHRE
The European IVF monitoring programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE). Assisted reproductive technology in Europe, 2001. Results generated from European Registers by ESHRE
Hum Reprod
 , 
2005
, vol. 
20
 (pg. 
1158
-
1176
)
ESHRE
The European IVF monitoring programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE). Assisted reproductive technology in Europe, 2002. Results generated from European Registers by ESHRE
Hum Reprod
 , 
2006
, vol. 
21
 (pg. 
1680
-
1697
)
ESHRE
The European IVF monitoring programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE). Assisted reproductive technology in Europe, 2003. Results generated from European Registers by ESHRE
Hum Reprod
 , 
2007
, vol. 
22
 (pg. 
1513
-
1525
)
Jain
T
Gupta
RS
Trends in the use of intracytoplasmatic spoerm injection in the United States
N Engl J Med
 , 
2007
, vol. 
357
 (pg. 
251
-
257
)
Sermon
KD
Michiels
A
Harton
G
Mouton
C
Repping
C
Scriven
PN
SenGupta
S
Traeger-Synodoinos
J
Vesela
K
Viville
S
, et al.  . 
ESHRE PGD Consortium data collection VI: cycles from January to December 2003 with pregnancy follow-up to October 2004
Hum Reprod
 , 
2007
, vol. 
22
 (pg. 
323
-
336
)
Vayena
E
Rowe
PJ
Griffin
PD
World Health Organization
Current practise and controversies in assisted reproduction 2002
2002
, vol. 
99
 
Geneva
World Health Organization
(pg. 
19
-
22
)
Wright
VC
Chang
J
Jeng
G
Chen
M
Macaluso
M
Assisted reproductive technology surveillance, United States
MMWR Surveillance Summaries
 , 
2007
, vol. 
56
 (pg. 
1
-
12
)
Zegers-Hochschild
F
Nygren
KG
Adamson
DG
de Mouzon
J
Lancaster
P
Mansour
R
Sullivan
E
on behalf of the International Committee Monitoring Assisted reproductive Technologies
The ICMART glossary on ART terminology
Hum Reprod
 , 
2006
, vol. 
a 21
 (pg. 
1968
-
1970
)
Zegers-Hochschild
F
Nygren
KG
Adamson
DG
de Mouzon
J
Lancaster
P
Mansour
R
Sullivan
E
ICMART glossary on ART terminology
Fertil Steril
 , 
2006
, vol. 
b 86
 (pg. 
16
-
19
)