Embed Size (px)
Citation preview
Figures from the 2015 Assisted Reproductive Technology
National Summary Report
Locations of ART Clinics in the United States and Puerto Rico, 2015
Number of ART clinics in the United States in 2015 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 499Number of ART clinics that submitted data in 2015 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 464Total number of ART cycles started in 2015 at clinics reporting data. . . . . . . . . . . . . . . . . . . . . . . . . . . . 231,936*
Number of live-birth deliveries resulting from ART cycles started in 2015 . . . . . . . . . . . . . . . . . . . . . . . . 60,778Number of infants born as a result of ART cycles started in 2015. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72,913
* Total includes 45,779 cycles with the intent to freeze all eggs or embryos. Live-birth deliveries and infants born are based on remaining 186,157 cycles with intent to transfer at least one egg or embryo. This includes 4,003 cycles with intent to fertilize previously frozen eggs and transfer resulting embryos. This does not include 1 cycle evaluating a new treatment procedure.
Types of ART Cycles—United States,* 2015
Fresh nondonor 39.3%
(91,090 cycles)
Frozen nondonor embryo 30.1%(69,882 cycles)
Egg/embryo banking 19.7%(45,779 cycles)
Frozen donor embryo 6.0%
(13,846 cycles)
Fresh donor 3.2%(7,336 cycles)
Frozen egg 1.7%(4,003 cycles)
New treatmentprocedure <0.1%
(1 cycle)
* Total does not equal 100% due to rounding.
ART Use by Age Group—United States,* 2015
Age: <3538.1%
Age: 35–3721.0%
Age: 38–4019.4%
Age: 41–4210.0%
Age: 43–446.4%
Age: >445.1%
* Based on 231,936 cycles.
Types of ART Cycles by Age Group—United States,* 2015
(53) (50) (52) (53)(46)
(19)
(4) (7) (12)(21)
(44) (45)(38)
(29)
(19)
(10)
(6)(11)
(22)
(50)
0
20
40
60
80
100
Perc
ent
Age (years)
Fresh nondonor Fresh donorFrozen nondonor Frozen donor
95%90%
82%
65%
29%
97%
4% 5%10%
18%
34%
71%
<35† 35–37 38–40 41–42 43–44† >44
* Percentages of ART cycles that used fresh or frozen embryos from nondonor or donor eggs are in parentheses.† Totals do not equal 100% due to rounding.
Percentages of ART Cycles That Resulted in Live Births, by Type of ART and Clinic Size—United States, 2015
26 2624 23
38 3840
424246
44 44
3437 37
41
0
10
20
30
40
50
60
<102 102–204 205–463 >463
Perc
ent
Clinic Size (number of ART cycles performed in 2015)Fresh nondonor Frozen nondonorFresh donor Frozen donor
Percentages of ART Cycles Using Fresh Embryos from Frozen Nondonor or Donor Eggs That Resulted in Cancellations, Pregnancies, Live Births, and
Single-Infant Live Births,* 2015
7.3
29.3
22.718.8
6.0
47.2
38.6
30.2
0
10
20
30
40
50
60
Cancellations Pregnancies Live births Single-infant live births
Perc
ent
Nondonor Donor
* Cycles using both nondonor and donor frozen eggs are excluded.
Outcomes of ART Cycles Using Fresh Nondonor Eggs or Embryos,by Stage, 2015
91,090 cycles
started 80,644 retrievals
59,336 transfers
26,708 pregnancies 21,771
live-birthdeliveries
0
20,000
40,000
60,000
80,000
100,000
Num
ber
Reasons ART Cycles Using Fresh Nondonor Eggs or Embryos Were Canceled, *† 2015
No or not enough egg production
82.3%
Patient withdrawal for other reasons
12.5%
Over response toovarian stimulation medication
4.2%
Concurrent illness0.9%
* Based on 10,446 ART cycles.† Total does not equal 100% due to rounding.
Percentages of ART Cycles and Transfers Using Fresh Nondonor Eggs orEmbryos That Resulted in Pregnancies, Live Births, and
Single-Infant Live Births, 2015
29.3
23.9
18.5
45.0
36.7
28.3
0
10
20
30
40
50
Pregnancies Live births Single-infant live births
Perc
ent
Cycles Transfers
Outcomes of ART Cycles Using Fresh Nondonor Eggs or Embryos, 2015
No pregnancy70.2%
Ectopic pregnancy0.5%
Single-fetus pregnancy
20.4%
Multiple-fetus
pregnancy6.9%
Not able to determine number of fetuses2.0%
Clinical pregnancy29.3%
Outcomes of Pregnancies That Resulted from ART Cycles Using Fresh Nondonor Eggs or Embryos,*† 2015
Single-infant birth63.0%
Multiple-infant birth
18.6%
Stillbirth0.7%
Miscarriage16.3%
Induced abortion0.9%
Unknown0.7%
Total live births 81.6%
* Maternal deaths prior to birth are not displayed due to small number of cycles.† Total does not equal 100% due to rounding.
Distribution of Multiple-Fetus Pregnancies and Multiple-Infant Live BirthsAmong ART Cycles Using Fresh Nondonor Eggs or Embryos, 2015
Single infants77.2%
Twins22.1%
Triplets or more
0.6%
B. 21,771 live births*
Single fetuses69.6%
Twins22.4%
Triplets or more
1.0%Not able to determine number of
fetuses7.0%
A. 26,708 pregnancies
* Total does not equal 100% due to rounding.
Percentages of Preterm Infants or Infants with Low Birth Weight from ART CyclesUsing Fresh Nondonor Eggs or Embryos, by Number of Infants Born, 2015
11.016.6
58.2
96.3
9.216.0
55.9
93.5
0
20
40
60
80
100
Single infantsfrom single-fetus
pregnancies
Single infantsfrom multiple-fetus
pregnancies
Twins Triplets or more
Perc
ent
Number of Infants Born
Preterm infants Low birth weight infants
Age Distribution of Women Who Had ART Cycles Using Fresh Nondonor Eggs or Embryos, 2015
0
1
2
3
4
5
6
7
8
9
10
24 26 28 30 32 34 36 38 40 42 44 46 48
Perc
ent
Age (years)<24 >48
Mean Median
Percentages of ART Cycles Using Fresh Nondonor Eggs or Embryos That Resulted in Pregnancies, Live Births, and Single-Infant Live Births,
by Age of Woman,* 2015
0
10
20
30
40
50
60
24 26 28 30 32 34 36 38 40 42 44
Perc
ent
Age (years)
Pregnancies Live births Single-infant live births
<24 >44
* For consistency, all percentages are based on cycles started.
Percentages of ART Cycles Using Fresh Nondonor Eggs or Embryos ThatResulted in Pregnancies, Live Births, and Single-Infant Live Births
Among Women Aged 40 or Older,* 2015
20
15
12
86
3
14
10
7
3 31
11
86
3 2 10
10
20
30
40 41 42 43 44 > 44
Perc
ent
Age (years)
Pregnancies Live births Single-infant live births
* For consistency, all percentages are based on cycles started.
Percentages of ART Cycles Using Fresh Nondonor Eggs or Embryos That Resulted in Miscarriage, by Age of Woman, 2015
0
10
20
30
40
50
60
70
24 26 28 30 32 34 36 38 40 42 44
Perc
ent
Age (years)<24 >44
Outcomes of ART Cycles Using Fresh Nondonor Eggs or Embryos, by Stage and Age Group, 2015
9389
8580 78 76
71 6862
5449
413832
23
147
3
3326
17
83 1
0
20
40
60
80
100
<35 35–37 38–40 41–42 43–44 >44
Perc
ent
Age (years)
Retrieval Transfer Pregnancy Live birth
Percentages of ART Cycles Using Fresh Nondonor Eggs or Embryos, by Type of Infertility Diagnosis,* 2015
14.3 13.9
30.8
8.85.3
34.8
12.8 13.911.0
17.7
0
10
20
30
40
Perc
ent
Diagnosis
* Total percentages are greater than 100% because more than one diagnosis can be reported for each cycle.
Percentages of ART Cycles Using Fresh Nondonor Eggs or Embryos That Resulted in Live Births, by Type of Infertility Diagnosis, 2015
24.028.8
13.1
27.6
17.3
27.1
18.5
29.0
17.322.0
0
10
20
30
40
Perc
ent
Diagnosis
Percentages of ART Cycles Using Fresh Nondonor Eggs or Embryos That Resulted in Live Births, by Age Group and
Number of Previous Live Births, 2015
32
25
16
8
31
37
28
18
84
1
34
29
17
10
3<1
0
10
20
30
40
50
<35 35–37 38–40 41–42 43–44 >44
Perc
ent
Age (years)
No previous live births 1 previous live birth 2 or more previous live births
Percentages of ART Cycles Using Fresh Nondonor Eggs or Embryos That Resulted in Live Births, by Age Group and History of Miscarriage,
Among Women with No Previous Births,* 2015
32.6
25.5
16.2
7.9
2.90.9
31.8
24.0
16.5
8.1
3.00.9
0
10
20
30
40
50
<35 35–37 38–40 41–42 43–44 >44
Perc
ent
Age (years)No previous pregnancies 1 or more previous miscarriages
* Women reporting only previous ectopic pregnancies or pregnancies that ended in induced abortion are not included.
Percentages of ART Cycles Using Fresh Nondonor Eggs or Embryos That Resulted in Live Births, by Age Group and Number of Previous ART Cycles,
Among Women with No Previous Live Births, 2015
34
28
19
9
31
29
23
1410
31
26
21
16
63
1
23
1511
52 1
0
10
20
30
40
50
<35 35–37 38–40 41–42 43–44 >44
Perc
ent
Age (years)No previous cycles 1 previous cycle2 previous cycles 3 or more previous cycles
Percentages of Retrievals Using Fresh Nondonor Eggs or EmbryosThat Used ICSI,* 2015
95.0 94.0 93.8 92.5 91.5 94.6
69.3 70.0 71.3 72.776.5 80.0
0
20
40
60
80
100
<35 35–37 38–40 41–42 43–44 >44
Perc
ent
Age (years)ICSI, with male factor ICSI, no male factor
* Cycles using GIFT are excluded.
Percentages of Fresh Nondonor Retrievals That Resulted in Live Births Among Patients with or Without Diagnosed Male Factor Infertility,
by Age Group and Use of ICSI,* 2015
37
31
22
11
41
38
30
21
11
4<1
34
28
19
10
41
0
10
20
30
40
50
<35 35–37 38–40 41–42 43–44 >44
Perc
ent
Age (years)
ICSI, with male factor No ICSI, no male factor ICSI, no male factor
* Cycles using GIFT are excluded.
Numbers of Embryos Transferred Among All Transfers Using Fresh Nondonor Eggs or Embryos,* 2015
One33.5%
Two52.3%
Three10.5%
Four2.5%
Five0.9%
Six0.2%
Seven or more0.1%
Unknown<0.1%
* Total does not equal 100% due to rounding.
Percentages of Embryos Transferred That Implanted Using Fresh Nondonor Eggs or Embryos, by Age Group, 2015
41.3
32.1
21.0
10.7
5.21.9
0
10
20
30
40
50
<35 35–37 38–40 41–42 43–44 >44
Perc
ent
Age (years)
Percentages of Transfers Using Fresh Nondonor Eggs or Embryos That Resultedin Live Births of Single, Term, and Normal Birth Weight Infants,
by Number of Embryos Transferred, 2015
30.3
22.4
15.3
10.7
0
10
20
30
40
1 2 3 4+
Perc
ent
Number of Embryos Transferred
Percentages of Transfers Using Fresh Nondonor Eggs or Embryos ThatResulted in Live Births and Distribution of Number of Infants Born,
by Number of Embryos Transferred,* 2015
(97.9)(65.7)
(75.0)(78.2)
(2.1) (33.6)
(22.0)
(19.7)
(<0.1)(0.6)
(3.0)
(2.1)
0
10
20
30
40
50
1† 2† 3 4+
Perc
ent
Number of Embryos TransferredSingle infants Twins Triplets or more
36.2%40.8%
25.0%
17.5%
* Percentages of transfers resulting in live births are shown on top of each bar graph. Percentages of live births that were single infants, twins, and triplets or more are in parentheses.
† Totals do not equal 100% due to rounding.
Percentages of Transfers Using Fresh Nondonor Eggs or Embryos That Resulted in Live Births and Distribution of Number of Infants Born
Among Good-Prognosis Women, by Number of Embryos Transferred,* 2015
(97.9)
(56.3) (62.4)(100.0)
(2.1)(42.7)
(28.2)
(<0.1)(1.0)
(9.4)
0
10
20
30
40
50
60
70
1† 2 3 4+
Perc
ent
Number of Embryos TransferredSingle infants Twins Triplets or more
49.5%56.2%
50.9%
44.4%
* Percentages of transfers resulting in live births are shown on top of each bar graph. Percentages of live births that were single infants, twins, and triplets or more are in parentheses.
† Total does not equal 100% due to rounding.
Day of Embryo Transfer* Among Transfers Using Fresh Nondonor Eggs or Embryos,†‡ 2015
Day 10.1%
Day 23.7%
Day 331.0%
Day 41.4%
Day 558.9%
Day 65.0%
* Number of days following egg retrieval.† Cycles using GIFT or ZIFT are excluded. Missing or implausible values for day of embryo transfer (that is, 0 or greater than 6)
are not included. ‡ Total does not equal 100% due to rounding.
Percentages of Day 3 and Day 5 Embryo Transfers Using Fresh NondonorEggs or Embryos That Resulted in Live Births, by Age Group,* 2015
34.929.6
21.7
12.0
5.00.5
50.3
43.6
32.4
19.6
9.1
3.2
0
10
20
30
40
50
60
<35 35–37 38–40 41–42 43–44 >44
Perc
ent
Age (years)
Day 3 Day 5
* Cycles using GIFT or ZIFT are excluded. Embryo transfers performed on days 1, 2, 4, and 6 are not included because each of these accounted for a small proportion of procedures.
Numbers of Embryos Transferred on Day 3 and Day 5 Among Transfers Using Fresh Nondonor Eggs or Embryos,* 2015
One20.1%
Two51.2%
Three20.1%
Four or more8.6%
Day 3
One38.6%
Two54.6%
Three5.8%
Four or more1.1%
Day 5†
* Cycles using GIFT or ZIFT are excluded. Embryo transfers performed on days 1, 2, 4, and 6 are not included because each of these accounted for a small proportion of procedures.
† Total does not equal 100% due to rounding.
Distribution of Number of Infants Born Among Day 3 and Day 5 EmbryoTransfers Using Fresh Nondonor Eggs or Embryos
That Resulted in Live Births,* 2015
Single infants79.2%
Twins20.0%
Triplets or more
0.8%
Day 3
A. 4,563 live births
Single infants76.3%
Twins23.1%
Triplets or more
0.6%
Day 5
B. 15,120 live births
* Cycles using GIFT or ZIFT are excluded. Embryo transfers performed on days 1, 2, 4, and 6 are not included because each of these accounted for a small proportion of procedures.
Percentages of Day 5 Transfers Using Fresh Nondonor Eggs or Embryos ThatResulted in Live Births and Distribution of Number of Infants Born Among
Good-Prognosis Women, by Number of Embryos Transferred,* 2015
(97.8)
(54.1) (71.0)
(2.2)(44.7) (19.4)
(<0.1)
(1.2)
(9.7)
0
10
20
30
40
50
60
70
1† 2 3+†
Perc
ent
Number of Embryos TransferredSingle infants Twins Triplets or more
50.0%
58.3%51.7%
* Percentages of transfers resulting in live births are shown on top for each bar graph. Percentages of live births that were single infants, twins, and triplets or more are in parentheses.
† Totals do not equal 100% due to rounding.
Percentages of Transfers Using Fresh Nondonor Eggs or Embryos That Resulted in Live Births Among ART Cycles That Used Gestational Carriers
and Those That Did Not, by Age Group,* 2015
56.1
46.8
26.9 25.0
18.2
33.3
46.4
38.4
27.5
15.5
6.61.7
0
10
20
30
40
50
60
<35 35–37 38–40 41–42 43–44 >44
Perc
ent
Age (years)
Used a gestational carrier Did not use a gestational carrier
* Age groups reflect the age of the ART patient, not the age of the gestational carrier.
Percentages of Embryos Transferred That Implanted Using Frozen Nondonor Embryos, by Age Group, 2015
47.143.6
38.3
31.4
23.4
16.2
0
10
20
30
40
50
<35 35–37 38–40 41–42 43–44 >44
Perc
ent
Age (years)
Percentages of Transfers Using Frozen or Fresh Nondonor Embryos ThatResulted in Pregnancies, Live Births, and Single-Infant Live Births, 2015
54.6
44.3
36.9
45.0
36.7
28.3
0
10
20
30
40
50
60
Pregnancies Live births Single-infant live births
Perc
ent
Frozen nondonor Fresh nondonor
Distribution of Multiple-Fetus Pregnancies and Multiple-Infant Live BirthsAmong ART Cycles Using Frozen Nondonor Embryos, 2015
Single fetuses75.0%
Twins16.4%
Triplets or more
0.6%Not able to determine number of
fetuses7.9%
A. 35,598 pregnancies*
Single infants83.3%
Twins16.4%
Triplets or more
0.4%
B. 28,869 live births*
* Totals do not equal 100% due to rounding.
Percentages of ART Cycles Using Donor Eggs or Embryos, by Age of Woman, 2015
0
10
20
30
40
50
60
70
80
90
100
24 26 28 30 32 34 36 38 40 42 44 46 48
Perc
ent
Age (years)
Donor embryo Fresh embryo fromfresh donor egg
Frozen embryofrom donor egg
<24 >48
Percentages of Transfers Using Fresh Embryos from Donor or Nondonor EggsThat Resulted in Live Births, by Age of Woman, 2015
0
10
20
30
40
50
60
70
80
90
100
30 32 34 36 38 40 42 44 46 >47
Perc
ent
Age (years)
Fresh donor Fresh nondonor
<30
Distribution of Multiple-Fetus Pregnancies and Multiple-Infant Live BirthsAmong ART Cycles Using Fresh Embryos from Donor Eggs, 2015
Single infants72.3%
Twins27.3%
Triplets or more
0.4%
B. 3,245 live births
Single fetuses65.4%
Twins27.4%
Triplets or more
0.9% Not able to determine number of
fetuses6.3%
A. 3,846 pregnancies
Percentages of Transfers Using Donor Eggs or Embryos That Resulted in Pregnancies, Live Births, and Single-Infant Live Births, 2015
49.5
39.0
30.3
65.9
55.6
40.2
52.7
42.835.4
0
10
20
30
40
50
60
70
80
90
100
Pregnancies Live births Single-infant live births
Perc
ent
Donor embryo Fresh embryo fromfresh donor egg
Frozen embryofrom donor egg
Numbers of ART Cycles Performed, Live-Birth Deliveries, and Infants Born Using ART, 2006–2015
0
25,000
50,000
75,000
100,000
125,000
150,000
175,000
200,000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Num
ber
Year
ART cycles Live-birth deliveries Infants born
Numbers of ART Cycles Performed for Banking All Fresh Nondonor Eggs or Embryos, 2006–2015
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
45,000
50,000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Num
ber
Year
Numbers of ART Cycles Using Donor Eggs or Embryos, 2006–2015
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Num
ber
Year
Donor embryo Fresh embryo fromfresh donor egg
Frozen embryofrom donor egg
Numbers and Percentages of Transfers Using Gestational Carriers, 2006–2015
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
4,500
5,000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Perc
ent
Num
ber
Year
Number Percent
Percentages of Retrievals Using Fresh Nondonor or Donor Eggs or EmbryosThat Used ICSI,* 2006–2015
0
10
20
30
40
50
60
70
80
90
100
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Perc
ent
Year
Overall Male factor No male factor* Cycles using GIFT are excluded.
Percentages of Transfers Using Fresh Nondonor Eggs or Embryos That Resulted in Single-Infant Live Births, by Age Group, 2006–2015
0
5
10
15
20
25
30
35
40
2006* 2007* 2008 2009 2010 2011 2012 2013 2014 2015
Perc
ent
Year
<35 35–37 38–40 41–42 >42 43–44 >44Age Group:
* Through 2006, data for women older than age 42 were combined. Starting in 2007, data for women older than age 42 were reported as women aged 43–44 and women older than age 44.
Percentages of Fresh Nondonor Transfers of One, Two, Three, or Four or More Embryos, 2006–2015
10.7 11.6 11.9 13.5 15.5 16.6 19.523.6
28.833.5
46.0 48.1 49.8 51.5 52.8 53.955.0
55.7 54.2 52.327.6 26.0 24.8 23.4 21.3 20.1 17.7 14.6 12.4 10.515.8 14.4 13.5 11.6 10.4 9.4 7.8 6.0 4.6 3.7
2006* 2007* 2008 2009 2010 2011 2012 2013* 2014 2015
Perc
ent
Year
One Two Three Four or moreNumber of Embryos Transferred
* Totals do not equal 100% due to rounding.
Percentages of Elective Single Embryo Transfer (eSET) Among All TransfersUsing Fresh Nondonor Eggs or Embryos, by Age Group,* 2006–2015
0
5
10
15
20
25
30
35
40
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Perc
ent
Year<35 35–37 38–40 >40Age Group:
* All ages older than 40 years are reported together due to the small number of transfers performed with eSET.
Percentages of Transfers Using Fresh Nondonor Eggs or Embryos ThatResulted in Live Births, by Number of Embryos Transferred, 2006–2015
0
10
20
30
40
50
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Perc
ent
Year
One Two Three Four or moreNumber of Embryos Transferred
Percentages of Live Births Using Fresh Nondonor Eggs or Embryos ThatResulted in Multiple Infants Born, by Age Group, 2006–2015
0
5
10
15
20
25
30
35
40
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Perc
ent
Year<35 35–37 38–40 41–42 >42Age Group:
Percentages of Single Infants, Twins, and Triplets or More Among ARTTransfers Using Fresh Nondonor Eggs or Embryos That
Resulted in Live Births, 2006–2015
69.3 68.8 68.4 69.5 69.7 71.3 72.6 73.4 75.7 77.2
28.8 29.4 29.8 28.9 28.8 27.5 26.4 25.7 23.3 22.1
1.9 1.8 1.8 1.6 1.5 1.3 1.0 0.9 0.9 0.6
2006 2007 2008 2009 2010 2011* 2012 2013 2014* 2015*
Perc
ent
Year
Single infants Twins Triplets or more
* Totals do not equal 100% due to rounding.
