Fertility Facts and Figures 2008

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1 Fertility Facts and Figures 2008

2 Contents About these statistics... 2 Accessing our data... 2 The scale of fertility problems... 3 Treatment abroad... 3 Contacts regarding this publication... 3 Latest annual figures Live birth rates by age... 5 Fresh and frozen IVF cycles... 6 Other IVF treatments... 6 Multiple births background... 7 Multiple births figures... 8 Average age of women treated... 9 Reasons for patients undergoing fertility treatment in About these statistics The Human Fertilisation and Embryology Authority (HFEA) collects data about around 50,000 treatments performed each year in the UK fertility sector. Clinics are required by law to provide information to the HFEA Register about all licensed fertility treatments they carry out. Before publication, a validation process is performed on the data, and clinics are asked to confirm its accuracy, for which they remain responsible. The information collected and published by the HFEA is a snap shot of data provided by licensed clinics at a particular time. This information may be subject to change as individual clinics notify us of amendments. The figures supplied in this document are derived from the HFEA data warehouse containing Register data as at 24 th November 2010 unless otherwise stated and include treatments carried out between 1st January and 31st December Our website, provides information about individual clinics, the fertility treatments available and a full glossary of terms. Accessing our data We publish a version of our Register in an anonymised form on our website. The data can be imported in to a spreadsheet or statistical package for analysis. The data is updated periodically and you can choose to be notified when this happens. 1 Some minor changes may have been made to the data for individual clinics since then and these will be reflected in the data provided on Choose a Fertility Clinic. Any changes are likely to be very minor and not make a significant difference to the versions published in this document 2

3 The scale of fertility problems Infertility is defined as failing to get pregnant after two years of regular unprotected sex by the National Institute for Health and Clinical Excellence (NICE). After pregnancy, infertility is the most common reason for women aged to see their GP. Fertility problems affect one in seven couples in the UK approximately 3.5 million people. Most couples (about 84 out of every 100) who have regular sexual intercourse (that is, every 2 to 3 days) and who do not use contraception will get pregnant within a year. About 92 out of 100 couples who are trying to get pregnant do so within 2 years. 2 Treatment abroad The HFEA licenses and regulates clinics in the UK only. We therefore have no information about treatment cycles that occurred outside the UK. Clinics in other countries may, or may not, be regulated to local standards and regulations. The EU Tissues and Cells Directive sets out standards of quality and safety that should be met within countries within the EU/EEA, but the HFEA recommends that in any case, wouldbe patients should research their chosen clinic thoroughly and ask about its standards of treatment and care. Further information about seeking treatment abroad can be found on our website. Future publications During 2011 we will implement a more formal publication schedule for our statistics. We plan to publish a report around October covering the annual statistics from 2009, plus a more indepth analysis of one particular area of fertility treatment around April. This cycle should then continue into the future. Contact us regarding this publication Media: Statistical: 2 National Institute for Health and Clinical Excellence (NICE). Fertility: assessment and treatment for people with fertility problems. Clinical guideline 11. London: NICE;

4 Latest annual figures The number of IVF cycles performed and the number of patients being treated has continued to rise 3,4. Intra-cytoplasmic sperm injection (ICSI a technique used to overcome some problems caused by the quality of sperm) represented 46% of all IVF treatment in 2008, a slight decrease on that seen in 2007 (48%). The remainder was conventional IVF % change In vitro fertilisation (IVF) 5 Number of cycles 44,275 46,829 50,687 Up 8.2% Number of patients 34,855 36,861 39,879 6 Up 8.2% Number of babies born through IVF 10,242 successful births giving rise to 12,596 babies 11,091 successful births giving rise to 13,672 babies 12,211 successful births giving rise to 15,082 babies Births up 10.1%, babies up 10.3% IVF live birth rate per cycle started Multiple birth rate following IVF 23.1% 23.7% 24.1% Up 0.4% 22.7% % Up 0.2% Donor insemination (DI) Number of DI treatment cycles 4,225 3,881 3,938 Up 1.5% Number of patients 2,106 1,779 1,916 Up 7.7% Number of babies born through DI 455 successful births giving rise to 489 babies 442 successful births giving rise to 472 babies 451 successful births giving rise to 487 babies Births up 2.0%, babies up 3.2% DI live birth rate per cycle started Multiple birth rate following DI 10.8% 11.4% 11.5% Up 0.1% 6.8% 6.6% 7.8% Up 1.2% figures published 2 October figures published 30 September IVF figures include all IVF, ICSI, PGD, PGS, natural cycles, treatments using donated eggs and those where fresh and frozen embryos were transferred in the same cycle. 6 Some women have more than one treatment cycle in a year. For this reason the number of treatment cycles started is always greater than the number of women starting treatment each year. 4

5 Percentage live births per cycle Percentage live births per cycle HFEA Fertility Facts & Figures 2008 Live birth rates by age The likelihood of getting pregnant following IVF or DI treatment is strongly linked to the age of the woman being treated. On average, a woman aged under 35 is substantially more likely to conceive than a woman who is older. Full live birth rates by age, treatment type and centre are published regularly and in more detail on our Choose a Fertility Clinic website. Figure 1a: Average live birth rate for IVF using own fresh eggs Figure 1b: Average live birth rate for Donor Insemination Under Over 44 0 Under Over 44 Woman's age at start of cycle 7 Data includes IVF and ICSI but does not include natural cycles, PGD cycles or cycles where both fresh & frozen embryos were used in the same cycle Woman's age at start of cycle IVF Live Birth Rate DI Live Birth Rate Age: Under Over 44 Age: Under Over % 27.7% 19.2% 11.9% 3.4% 3.1% % 12.1% 4.6% 1.4% 0% % 27.2% 19.3% 12.5% 4.9% 2.5% % 11% 4.8% 1.1% 0% 5

6 Fresh and frozen IVF cycles 8 Just over 80% of IVF cycles were fresh cycles, the remainder used frozen embryos. Fresh IVF Frozen IVF Number of cycles 39,334 8,959 Number of patients 33,520 7,792 Number of births 10,010 1,618 Number of babies 12,480 1,855 Live birth rates by age: Under % 22.2% % 17.8% % 15.8% 40 and over 10.7% 11.9% 8 Cycles where the patient s own eggs used only. This data includes IVF and ICSI but does not include natural cycles, PGD cycles or cycles where both fresh and frozen embryos were used in the same cycle Other IVF treatments Donated eggs 63 clinics offered this treatment in Number of cycles 1,700 Number of patients 1,511 Number of births 485 Number of babies 630 Live birth rate 28.5% Read more about egg donation on our website Pre-implantation Genetic Diagnosis (PGD) 10 clinics offered this treatment in Number of cycles 214 Number of patients 182 Number of births 54 Number of babies 66 Live birth rate 25.2% Read more about PGD on our website 6

7 Multiple births background Risks of multiple births Multiple births (twins and triplets) are the single biggest health risk associated with fertility treatment. Multiple births carry risks to both the health of the mother and the babies: Mothers have a higher risk of miscarriage and other complications in pregnancy The babies are more likely to be premature and to have a low birth weight The risk of death within the first week of life is more than four times greater for twins than for a single baby The risk of cerebral palsy is five times higher for twins and 18 times higher for triplets than for a single baby Minimising the risks of multiple births For this reason, the HFEA restricts the number of embryos that can be transferred in IVF to a maximum of two for women under 40; and three for women aged 40 or over who are using their own eggs (for those using donated eggs, the maximum is two because these eggs will be from donors who are not older than 35). However whilst this has effectively reduced triplet births, the proportion of twin births remains high. The only way to reduce the risk of multiple births is to transfer just one embryo (single embryo transfer) in the patients who are most likely to get pregnant and therefore also most at risk of having twins. In January 2009 the HFEA introduced the following policy to promote single embryo transfer and minimise the risk of multiple births from IVF treatment: - The HFEA sets a maximum multiple birth rate that clinics should not exceed; this is lowered each year with an ultimate aim is 10% multiple births. - The Year 1 (2009) target was 24% multiple births and the Year 2 (2010) target is 20%. The Year 3 (2011) target will be set in December All centres have their own strategy setting out how they will not exceed the maximum multiple birth rate. The data presented in this report is for treatments started in 2008, before the policy was introduced. However the most recent pregnancy data shows that the multiple pregnancy rate has decreased as centres carry out more single embryo transfers in patients most at risk of conceiving a multiple pregnancy. National strategy: One at a Time The HFEA policy is part of a wider national strategy to reduce the risk of multiple births from fertility treatment involving representatives from professional bodies, patient groups and NHSfunding bodies. The One at a Time campaign provides centres with the tools to change their clinical practice, works to improve NHS funding of fertility treatment, provides information to patients and aims to share best practice across the sector. Read more about reducing the risk of multiple births from fertility treatment on the One at a Time website 7

8 Multiple births figures All types of IVF 9 Multiple births are generally more common in younger women. The high rate of multiples in women aged over 44 is thought to occur because they are more likely to be treated with donated eggs which will have come from younger women. Number of births by age Singleton Births Multiple Births Proportion of live births which were multiples Under 35 4,555 1, % , % , % % % Over % 9 Includes all IVF, ICSI, PGD, PGS, natural cycles, treatments using donated eggs and those where fresh and frozen embryos were transferred in the same cycle. Donor insemination Number of births by age Singleton Births Multiple Births Proportion of live births which were multiples Under % % % % % Over % 8

9 Average age of women treated 10 The average age of women treated in 2008 was 35.2 years for IVF and 35.1 years for donor insemination (DI). This has not changed since Since 1991 the average age of women treated has increased 1.6 years from 33.6 for IVF, and 3.2 years from 31.9 for DI. Around two thirds of women treated in 2008 were aged 37 or under (64.9%). Figure 2: How the average age of women treated has changed for IVF and DI Figure 3: Age of women starting treatment in , 3.8% Over 44, 1.7% 40-42, 13.9% 38-39, 15.6% Under 35, 40.3% 35-37, 24.6% 10 Data correct at 08/10/2010 9

10 Reasons for patients undergoing fertility treatment in Approximately equal numbers of patients sought treatment for male (29.7%) or female (28.5% in total) factors. A further one in ten patients received treatment because of both male and female factors. Nearly a quarter of patients treated had unexplained infertility. Figure 4: Reasons for seeking fertility treatment in Patients receiving IVF treatment only; other factors includes those with numerous multiple diagnoses. These figures do not sum precisely to 100%, this is because of missing data (0.8%) and the effects of rounding. Data correct at 08/10/

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