Europe reports 1.15 million fertility treatment cycles in 2023

Europe reports 1.15 million fertility treatment cycles in 2023

Assisted reproductive technology (ART) usage across Europe reached 1,156,316 treatment cycles in 2023, resulting in 247,021 births. Preliminary data presented at the 42nd Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE) in London shows that clinical practice is evolving toward a heavier reliance on embryo cryopreservation.

The figures, collected by the European IVF Monitoring (EIM) Consortium from 1,473 fertility centres across 36 European countries, highlight a shift in methodology. Frozen embryo transfer (FET) emerged as a dominant trend in 2023, accounting for 401,483 cycles. This represents almost 43% of treatment cycles when compared to 388,345 intracytoplasmic sperm injection (ICSI) cycles and 158,649 in vitro fertilisation (IVF) cycles.

The EIM Consortium has tracked the evolution of these practices since 1997, documenting more than 15.8 million ART treatment cycles and over 3.27 million infants across Europe. Among countries with complete reporting, the average number of ART treatment cycles per million inhabitants was 2,547, which is more than the estimated global need of at least 1,500 cycles per million people annually.

Clinical delivery rates per embryo transfer remained broadly stable in 2023: 27.6% for FET, 24.4% for IVF and 23.5% for ICSI. When measured per aspiration or thawing, the delivery rates were 24.7% for FET, 18.9% for IVF and 17.2% for ICSI.

Efforts to increase patient safety have led to a decrease in the number of embryos transferred per treatment. This shift resulted in the lowest recorded rates of triplet and twin deliveries since European monitoring began.

"The latest data demonstrate not only the continued high utilisation of ART, but also the ongoing evolution of clinical practice. The increase of frozen embryo transfer and continued reduction in multiple embryo transfers reflect a sustained commitment to improving both effectiveness and safety for patients."

Professor Diane De Neubourg, Chair of the EIM Consortium, via ESHRE

While reporting for fertility preservation remains incomplete, the preliminary 2023 data include more than 32,000 procedures. Complication rates were reported as low, though the Consortium noted these may be under-reported. Reported events included ovarian hyperstimulation syndrome in 1,760 cycles (0.18%), bleeding in 965 cycles (0.10%) and infection in 218 cycles (0.02%). Four maternal deaths were reported.

The growth in European ART follows a similar upward trajectory seen in other regions. In the United States, CDC data from 2017 indicated nearly 200,000 ART procedures, contributing to 1.9% of all births. This was nearly double the 1% reported in 2001, a rise attributed to the acceptance of technology, increased success rates and delayed childbearing.

Research into the long-term health of children conceived via ART is ongoing. A study of children in New York State, followed from infancy to ages 8–10, found that clinical measures at age 9 did not indicate greater cardio-metabolic risk for children conceived by ART or ovulation induction compared to those conceived without treatment. The study noted that while some twins conceived via ovulation induction showed higher arterial stiffness, this was attenuated after accounting for maternal blood pressure.

To further refine data collection, ESHRE is transitioning a pilot study into a permanent data collection programme called the European Monitoring of Medically Assisted Reproduction (EuMAR). This pan-European registry will collect prospective, cycle-by-cycle data on treatments and outcomes.

"The EIM registry enables clinics, researchers and policymakers to monitor long-term trends in treatment and outcomes, supporting evidence-based improvements in patient care across Europe."

Professor Dr Anis Feki, Chair of ESHRE, via ESHRE