O-161 ICMART Preliminary World Report 2021

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Abstract Study question In 2021 what was the global utilization, effectiveness and safety of ART? Summary answer Globally, ART utilization and data collection continue to increase but with wide variations in utilization, effectiveness and safety. What is known already ICMART has continuously monitored utilization, effectiveness and safety since 1991, with increasing number of cycles, higher pregnancy rates and lower multiple birth rates, the latter due to the transfer of fewer embryos. Frozen embryo transfer (FET), donor egg cycles and preimplantation genetic testing (PGT) continue to increase. Wide variations in practice and outcomes exist globally. At least 13 million ART babies have been born. ICMART has helped develop registries internationally. Study design, size, duration Countries and regions annually collect ART data, some prospectively and others retrospectively. ICMART retrospectively requested data from all known global sources for 2021, reviewed them for missing or incorrect data, and obtained additional information when possible. The corrected dataset was validated and analyzed in partnership with the University of New South Wales (UNSW). ICMART finalized the results tables. Standardized definitions and previously developed methods were used. Preliminary results are presented. Participants/materials, setting, methods The European IVF Monitoring Consortium (EIM), Latin American Network of Assisted Reproduction (REDLARA), Australian/ New Zealand Registry and African Network and Registry for ART (ANARA) submitted regional data, stratified by country, and other countries contributed national data through standardized formats to ICMART. A few individual clinics with no registry access also contributed. Data received were reviewed, corrected, and validated to the extent possible, analyzed and summarized by ICMART using descriptive statistics. Main results and the role of chance Data collection and analysis are ongoing, so the results presented are preliminary. The number of ART cycles continues to increase, but utilization remains highly variable among countries and regions. While historically Europe has reported the largest number of cycles, China now reports well over 1 million cycles and Japan almost half a million, with Asia overall reporting approximately half of global cycles. Regional and country differences persist in the age of women treated, number of embryos transferred, live birth rates, rate of multiple births, use of ICSI, PGT and cryopreservation, and other factors. Covid reduced ART utilization in many countries in 2020 with some subsequent recovery in 2021. The role of chance is minimal. Data are limited to reporting countries and clinics. This is a very large sample size from which imputation of total global results is performed. Limitations, reasons for caution Most, but not all, countries report to ICMART. Some countries have limited data and many countries have limited data validation. ICMART can perform only minimal verification of submitted data. Similarly, ICMART cannot verify full adherence to the consensus definitions provided in the International Glossary. Additionally, these definitions might be impacted by translations where required or applicable. Standardization of validation and reporting is an ongoing process because of missing data and continuing changes in clinical practice. Wider implications of the findings ICMART World Reports standardize data, track trends, enable comparisons, stimulate questions and improve ART quality. Better understanding of ART increases societal acceptance and support for equitable access and ART research.

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