European IVF Monitoring (EIM) Year: 2010 Name of country: Poland Name and full address of contact person: Professor Rafal Kurzawa, MD PhD Fertility and Sterility Special Interest Group Polish Gynaecological Society Department of Reproductive Medicine and Gynaecology Siedlecka 2 Street 72-010 Szczecin Poland Telephone: +48 601 776 305 Fax: +48 91 818 39 89 E-mail: spin@spin.org.pl Strona 1 z 9
Module 0 Number and size of ART / IUI clinics a/ in the country ART clinics (units) IUI labs* 38 unk Total number of units in the country Total number of units reporting to 29 27 the National Register * Put in this column all the labs providing IUI (including those performing ART b/ Size of the reporting clinics. Number of ART clinics* Number of IUI labs** 10 3 < 100 cycles 2 1 100-199 cycles 10 11 200-499 cycles 6 9 500-999 cycles 1 3 1.000 cycles *Based on the total annual number of initiated cycles for the purpose IVF, ICSI, FER and ED (recipient cycles) ** Based on the total annual number of cycles with IUI (spouse or donor sperm) c/ Register characteristics Reporting requirement 1. Compulsory ; 2. Voluntary 2 Responsibility for the register. 1. National Health Authority ; 2. Medical Organization; 2 3. Other (describe) Reporting methods : Cycles. 1. Individual cycles; 2. Summaries of cycles reported by the clinics 2 Deliveries. 1. Individual cycles; 2. Summaries of deliveries reported by the clinics 2 Is there any kind of data validation process: 0. No; 1. Yes. 1 If yes, describe by coordinator Do patients have access to individual clinic data: 0. No; 1. Yes 0 Register financial support: 1. Public; 2. Centres; 3. Industry; 4. Public+industry; 5. 2 Centres + industry; 6. Public + centres + industry, professional society National number of deliveries in the same year in the country 409 387 National number of infants born in the same year in the country 415 030 Comments Strona 2 z 9
Initiated cycles**** Aspirations/Thawings (FER)**** Transfers Pregnancies, total***** Pregnancies with unknown outcome Deliveries***** Module 1 a Number of treatments, pregnancies and deliveries Cycles with women s own oocytes ED*** Fresh cycles * FER* PGD** Fresh FER IVF ICSI IVF/ICSI Fresh FER cycle 347 8621 256 236 ---- ---- ---- 335 8501 3733 256 0 231 12 313 7473 3550 159 0 336 12 125 2937 866 57 0 144 6 59 412 178 35 0 8 0 56 2233 549 17 0 108 6 * Excluding PGD and ED (Egg donation) ** Including both PGD and PGS irrespective of whether or not IVF or ICSI has been performed. *** In egg donation, initiated cycles and aspirations refer to the donor, whereas transfers, pregnancies and deliveries to the recipient and include both fresh and frozen embryo replacements **** If there is a discrepancy between the numbers of cycles and of aspirations in your country (some centres sending only one of the 2 numbers), please indicate this in a note. ***** Please use the WHO/ICMART definition of clinical pregnancy: evidence of pregnancy by clinical or ultrasound parameters (ultrasound visualisation of a gestational sac). It includes ectopic pregnancy. Multiple gestational sacs in one patient are counted as one clinical pregnancy. Deliveries include those resulting in a live birth and/or stillbirth. Among the fresh aspiration cycles, how many were performed: - with semen donation: 310* *12 cases husband and donor semen were used - with surgically obtained spouse s semen: 149 In vitro maturation (IVM) and frozen oocyte replacements (FOR) IVM Aspirations Transfers Pregnancies Deliveries 80 69 22 13 FOR Thawings Transfers Pregnancies Deliveries 40 32 10 8 Is embryo donation allowed in your country:? 0. No; 1. Yes: If yes, Embryo donation Transfers Pregnancies Deliveries 241 75 49 1 Comments for ED (embryo donation): 1. Transfers 8 cases were performed with mixed transfers oocyte and embryo donation 2. Pregnancies 4 cases after mixed transfers oocyte and embryo donation 3. Deliveries 3 cases after mixed transfers oocyte and embryo donation Strona 3 z 9
Module 1b Results by women s age and ART technique Number of initiated cycles in specific age groups in relation to treatment. IVF ICSI Woman s age Cycles Pregnancies Deliveries Cycles Pregnancies Deliveries 220 89 37 5254 2042 1340 34 105 33 17 2516 781 481 35-39 22 3 2 838 111 64 40 unknown 0 0 0 13 3 348 FER (Frozen embryo transfers) ED (Egg donations) Woman s age Cycles Pregnancies Deliveries Transfers Pregnancies Deliveries 2325 610 398 82 32 27 34 1070 207 126 114 54 39 35-39 299 49 24 152 64 48 40 unknown 39 0 1 0 0 0 Comments: IVF 59 pregnancies with unknown outcome ICSI 412 pregnancies with unknown outcome FER 178 pregnancies with unknown outcome ED 8 pregnancies with unknown outcome Strona 4 z 9
Module 1c Complications to treatments and foetal reduction Complications with medical intervention Number of occurrences Severe Hyperstimulation syndrome (grade 3 +) Complications to oocyte retrieval: All Bleeding Infection Maternal death (give the details) Number of Foetal reductions 56 33 29 4 0 0 OHSS definition: Grade 3 - Abdominal distension and discomfort (grade 1) - plus nausea, vomiting and/or diarrhoea, ovaries 5-12cm - plus ultrasonic evidence of ascites (grade 3) Grade 4 : Grade 3 + clinical evidence of ascites and/or hydrothorax or dyspnoea Grade 5 : All above plus haemoconcentration, coagulation abnormalities, diminished renal perfusion Strona 5 z 9
Module 2 Results by number of transferred embryos a / All IVF and ICSI fresh cycles Number of transferred embryos 1 2 3 4 5 unknown Total** Transfer cycles 1532 5326 646 36 5 241 7786 Clinical pregnancies 423 2317 208 12 1 101 3062 Pregnancy losses* 57 217 27 1 0 0 302 Deliveries: Total 323 1807 149 9 1 0 2289 Singleton 317 1413 115 8 1 0 1854 Twin 6 388 31 1 0 0 426 Triplet + 0 6 3 0 0 0 9 Unknown 0 0 0 0 0 0 0 Lost to Follow-up 43 293 32 2 0 101 471 b / All FER cycles (coming from IVF and ICSI) Number of transferred embryos 1 2 3 4 5 unknown Total** Transfer cycles 824 2205 397 34 0 90 3550 Clinical pregnancies 168 589 83 6 0 20 866 Pregnancy losses* 35 95 8 1 0 0 139 Deliveries: Total 115 375 57 2 0 0 549 Singleton 114 325 48 2 0 0 489 Twin 1 50 9 0 0 0 60 Triplet + 0 0 0 0 0 0 0 Unknown 0 0 0 0 0 0 0 Lost to Follow-up 18 119 18 3 0 20 178 c / Egg donation (ED) and PGD* Number of transferred embryos ED unknown 1 2 3 4 5 Total ED** Transfer cycles 86 219 41 2 0 0 348 159 Clinical pregnancies 29 105 14 2 0 0 150 57 Pregnancy losses** 10 14 4 0 0 0 28 5 Deliveries: Total 14 88 10 2 0 0 114 17 Singleton 12 70 7 0 0 0 89 14 Twin 1 18 3 2 0 0 24 3 Triplet + 0 0 0 0 0 0 0 0 Unknown 1 0 0 0 0 0 1 0 Lost to Follow-up 5 3 0 0 0 0 8 35 * This table concern all ED and PGD transfers, with fresh and frozen embryos ** Abortions and ectopic pregnancies *** Total=same numbers as in module 1a for transfers, pregnancies and deliveries PGD Total Strona 6 z 9
Module 3 Intrauterine Insemination (IUI) IUI-Homologue (Husband semen) Woman < 40 years Woman > 40 years Total Number of IUI-H cycles* Pregnancies** 11118 772 11890 1299 58 1357 Deliveries: Total 855 34 889 Singleton 757 29 786 Twin 55 3 58 Triplet + 0 0 0 Unknown 43 2 45 IUI-Donor (Donor sperm) Woman < 40 years Woman > 40 years Total Number of IUI-D cycles* Pregnancies** 1749 169 1918 368 24 392 Deliveries: Total 255 15 270 Singleton Twin 230 11 241 18 3 21 Triplet + 0 0 0 Unknown 7 1 8 * Whether one or more insemination were performed during the same cycle **Please use the WHO/ICMART definitions in relation to pregnancies (see module 1A) Comments: IUI-H 282 pregnancies with unknown outcome IUI-D 63 pregnancies with unknown outcome Strona 7 z 9
Module 4 (Optional) Gestational Age by Treatment and Multiple deliveries a) Fresh cycles (standard IVF, ICSI*) Gestational age (weeks since OPU + 2) Deliveries** All 20-27 28-32 33-36 37-41 42 + NA Singleton 861 25 115 113 499 4 105 Twin 191 8 15 61 91 0 16 Triplet or higher 5 1 2 2 0 0 0 Unknown 0 0 0 0 0 0 0 Total 1057 34 132 176 590 4 121 * Including PGD pregnancies with fresh transfer **Deliveries, not babies b) Frozen embryo transfers after standard IVF or ICSI* Gestational age (weeks since OPU + 2) Deliveries** All 20-27 28-32 33-36 37-41 42 + NA Singleton 360 13 23 50 253 7 14 Twin 42 2 5 14 21 0 0 Triplet or higher 0 0 0 0 0 0 0 Unknown 0 0 0 0 0 0 0 Total 402 15 28 64 274 7 14 * Including PGD pregnancies with FER **Deliveries, not babies c) Oocyte donation (ED) Gestational age (weeks since OPU + 2) Deliveries All 20-27 28-32 33-36 37-41 42 + NA Singleton 78 1 3 13 57 0 4 Twin 22 0 2 7 10 0 3 Triplet or higher 0 0 0 0 0 0 0 Unknown 1 0 0 0 0 0 1 Total 101 1 5 20 67 0 8 Deliveries, not babies NA Not available Comments: Data from 11 clinics Strona 8 z 9
Module 5 (Optional) Cycles performed for cross-border patients* a. Summary of cycles ART IUI Woman s own oocytes, spouse s semen Oocyte donation Sperm donation Other/ unknown Sperm donation IVF* ICSI* GIFT PGD Anonymous Non All All All anonymous Initiated cycles 140 103 3 29 229 b. Countries of patients origin and main reasons Main Countries of origin Reason Cycles Country cycles Legal Illegal technique in 92 home country 1. Germany 212 Illegal patients characteristics*** 2. United Kingdom 9 Access Care more expensive 10 in home country 3. Ireland 4 Distance, waiting list 3 4. Italy 3 quality Previous failures 2 5. USA 2 Other Unknown 130 6. Others (total) 7 * Patients living in a different country from the one they had ART ** Indicate the 5 main countries of patients origin and give the number of cycles for each of them. Give the total number of cycles for the others ***like age limitation, legal couple status, sexual orientation Strona 9 z 9