Irish uptake of assisted reproduction treatment well below European average
For the first time cumulative data is available from six Irish IVF clinics providing a reference on assisted reproductive treatment and outcomes for practicing doctors in Ireland. The paper is published in the latest edition of the Irish Medical Journal.
Access to IVF in Ireland is currently easier than it was 20 years ago, though it is still almost exclusively privately financed. The authors note that “Ireland lags far behind its European counterparts in terms of ART uptake. A potential reason is the lack of state funding of fertility therapy.”
The study considers ten years of information providing number of treatments, outcomes, female age at treatment, multiple pregnancy rates, as well as recommendations in the area of assisted reproduction technology (ART) in Ireland.
The largest group of patients belonged to the 35 to 39 year age group. This has remained constant throughout the ten years.
Compared to European averages, Ireland constantly had the lowest numbers seeking treatment in the under 29 age category. Variation occurred in 2008 with the younger age group increasing “possibly due to better patient education and the realisation that fertility declines with female age”, the authors note.
Research found that since 1999 a total of 24,378 cycles of ART have commenced. An increased number of treatment clinics and reporting in recent years have thus greatly expanded the number of treatments. Variants in clinic activity range from 200 to over 1000 cycles initiated annually.
The number of treatment cycles has constantly increased in IVF (257%), ICSI (231%) and FET (385%). [Intra-uterine Insemination (IUI), In-Vitro Fertilisation(IVF), Intra-Cytoplasmic Sperm Injection (ICSI) and Frozen Embryo Transfers (FET)].
Despite these increases, Ireland (762 cycles/ million inhabitants) is found lagging behind the average European incidence of ART treatments (850/ million inhabitants).
Denmark reports the highest number of treatment occurrences (2268/ million inhabitants, 2006 data), with Ireland proportionately reporting one third of their treatment numbers. .
With regard to multiple pregnancy, 2008 saw a shift from two to single embryo transfers bringing an increase in singleton and significant decrease in twin pregnancies. An increase in elective single embryo transfers (eSET) is evident with a significant rise in 2007 and 2008.
eSET is compulsory in some European countries, where the state understands the right of couples to have financial access to advanced fertility treatment and the enormous social and fiscal burden of multiple pregnancies resulting from ART
All these changes are in line with European practices with the exception of an orchestrated effort to promote (eSET) on a large scale.
“Pregnancy rates in Ireland have consistently been above European averages despite the higher age of the female population treated,” states author Dr Naasan (Human Assisted Reproduction Ireland).
ART treatments in Ireland appear to be very safe with complication rates well within European benchmarks.
Difference presents in the promotion of elective single embryo transfers (eSET) as in other European states. The authors find this an area of priority for the future requiring political commitment to support and publically fund ART.
All references and author names are contained in the full article in this month’s IMJ, p.136:
Title: “Assisted Reproductive Technology Treatment Outcomes”
See also www.imj.ie
May 2012 ■ Volume 105 ■ Number 5
Official Journal of the Irish Medical Organisation
For further information contact:
Irish Medical Organisation
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Note to editor:
Infertility is a World Health Organization (WHO) recognised disease. The International Committee Monitoring Assisted Reproductive Technologies (ICMART) and the WHO have recently agreed a glossary of Assisted Reproductive Technology (ART) terminology describing infertility as a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.