Test Tube Babies On the Rise Worldwide

More than 200,000 babies were born worldwide with the help of in vitro fertilization and other reproductive technologies in 2002, with a 25 percent increase between 2000 and 2002, according to a new report. However, the "Octomom" aside, multiple births resulting from assisted reproductive technologies (ART) have been on the decline, with Europe and Australia-New Zealand leading the way in the reduction of multiples, say the scientists responsible for the report published online today in the journal Human Reproduction. (Multiple births, rather than being seen as a success, are considered a serious medical complication with potentially harmful effects for both babies and mom.) The report included 2002 data from 1,563 clinics in 53 countries with data missing from some countries, mostly in Asia, Africa, Oceania and the West Indies. The authors estimated the "missing" countries likely performed 10 percent to 20 percent of ART procedures, and the researchers took this into account when calculating worldwide numbers. Here are more report highlights:

• The transfer of multiple embryos has decreased, leading to a slight decline in multiple births.
• Overall, the percentage of four or more embryo transfers decreased from 15.4 percent in 2000 to 13.7 percent in 2002, the most recent year for which world figures are available.
• The proportion of twin and triplet pregnancies decreased from 26.5 percent to 25.7 percent, and from 2.9 percent to 2.5 percent, respectively.
• Europe and Australia-New Zealand reported triplet rates (associated with ART) that were about half those of the United States and five-fold less than Latin America.
• The United States showed the highest pregnancy rates resulting from ART.
• Between 2000 and 2002, the use of intracytoplasmic sperm injection, or ICSI (an individual sperm cell is introduced into each egg obtained through the in vitro fertilization process), increased from 54 percent to 61 percent in North America, and 46 percent to 54 percent in Europe. In Latin America, ICSI reached 76 percent in 2002 and 92 percent for the Middle East.

Jacques de Mouzon is a specialist in public health who led the International Committee for Monitoring Assisted Reproductive Technology (ICMART), which compiled the report. He said the report is important because, "even if it is imperfect, it gives data that can inform debate and decision-making on issues such as availability and the benefits and risks of this important medical practice." He added, "It allows us to make comparisons between countries and regions, and to analyze trends by comparing with previous reports."

However, the authors warn that variation in data quality, in addition to differences in practices, legislation, guidelines, culture and religion, mean that comparisons between countries "must be done with caution."

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ICMART receives financial support from the American Society for Reproductive Medicine, Bertarelli Foundation, European Society for Human Reproduction and Embryology, Fertility Society of Australia, Latin American Network for Reproductive Medicine, Middle East Fertility Society and Society for Assisted Reproductive Technology.

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