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Hum. Reprod. Advance Access published online on February 18, 2009
Human Reproduction, doi:10.1093/humrep/dep035
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© The Author 2009. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Assisted reproductive technology and intrauterine inseminations in Europe, 2005: results generated from European registers by ESHRE

ESHRE. The European IVF Monitoring Programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE)

A. Nyboe Andersen1, V. Goossens, S. Bhattacharya, A.P. Ferraretti, M.S. Kupka, J. de Mouzon, K.G. Nygren{dagger} and The European IVF-monitoring (EIM) Consortium, for the European Society of Human Reproduction and Embryology (ESHRE)

ESHRE Central Office, Meerstraat 60 B-1852, Grimbergen, Belgium

1 Correspondence address. The Fertility Clinic 4071, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark. Tel: +45-35-45-13-15 or +45-35-45-49-76; Fax: +45-35-45-49-46; E-mail: anders.nyboe.andersen{at}rh.regionh.dk


   Abstract
Top
 Abstract
Introduction
 Materials and Methods
 Results
 Comments
 Supplementary data
 Appendix
 References
 
BACKGROUND: Results of assisted reproductive techniques from treatments initiated in Europe during 2005 are presented in this ninth report. Data were mainly collected from existing national registers.

METHODS: From 30 countries, 923 clinics reported 418 111 treatment cycles including: IVF (118 074), ICSI (203 329), frozen embryo replacement (79 140), oocyte donation (ED, 11 475), preimplantation genetic diagnosis/screening (5846) and in vitro maturation (247). Overall, this represents a 13.6% increase since 2004, partly due to inclusion of 28 417 cycles from Turkey. European data on intrauterine insemination using husband/partner's semen (IUI-H) and donor semen (IUI-D) were reported from 21 countries and included 128 908 IUI-H and 20 568 IUI-D cycles.

RESULTS: In 16 countries where all clinics reported to the IVF register, 1115 cycles were performed per million inhabitants. For IVF, the clinical pregnancy rates per aspiration and per transfer were 26.9% and 30.3%, respectively. For ICSI, the corresponding rates were 28.5% and 30.9%. After IUI-H, the clinical pregnancy rate was 12.6% per insemination in women <40. After IVF and ICSI, the distribution of transfer of one, two, three and four or more embryos was 20.0%, 56.1%, 21.5% and 2.3%, respectively. Huge differences exist between countries. The distribution of singleton, twin and triplet deliveries after IVF and ICSI was 78.2%, 21.0% and 0.8%, respectively. This gives a total multiple delivery rate of 21.8% compared with 22.7% in 2004 and 23.1% in 2003. In women <40 years of age, IUI-H was associated with a twin and triplet pregnancy rate of 11.0% and 1.1%, respectively.

CONCLUSIONS: Compared with earlier years, there was an increase in the reported number of ART cycles in Europe. Although fewer embryos were transferred per treatment, there was a marginal increase in pregnancy rates and a reduction in multiple deliveries.

Key words: European Society of Human Reproduction and Embryology/IVF/ICSI/IUI/European data registers


   Introduction
Top
 Abstract
 Introduction
Materials and Methods
 Results
 Comments
 Supplementary data
 Appendix
 References
 
This report is the ninth annual European Society of Human Reproduction and Embryology (ESHRE) publication on European data on assisted reproductive technology (ART). The eight previous reports, also published in Hum Reprod (ESHRE, 2001aGo, bGo, 2002Go, 2004Go, 2005Go, 2006Go, 2007Go, 2008Go), covered treatment cycles from 1997 to 2004.

Data have been collected from 30 European countries on ART covering IVF, ICSI, frozen embryo replacement (FER), oocyte donation (ED), in vitro maturation (IVM) and pooled data on preimplantation genetic diagnosis (PGD) and screening (PGS) during 2005. In addition to ART treatments, data on intrauterine inseminations using husband/partner's semen (IUI-H; 21 countries) and donor semen (IUI-D; 16 countries) were also included.

The annual meeting with the European IVF Monitoring (EIM) Consortium was held at the ESHRE meeting in Barcelona in July 2008 with representatives from the participating countries. The present and future reporting systems were discussed. Croatia and the Czech Republic were able to provide data for 2005, and the Turkish National ART Register provided data from 61 out of 93 clinics in the country.

The Consortium noted that the proportion of clinics reporting data had risen substantially in Italy and Spain, but needed to increase in Greece. In Eastern Europe, a number of countries do not yet participate in the EIM.

The reporting forms used for the 2005 data are similar to previous years, but the Consortium agreed on new forms, in order to gradually increase the quality and value of the data. One major change that will take effect from next year is stratification of results by female age.

The Consortium decided to continue to present annual reports and try to improve the quality of the reports.


   Materials and Methods
Top
 Abstract
 Introduction
 Materials and Methods
Results
 Comments
 Supplementary data
 Appendix
 References
 
Data collection
The present report summarizes data from ART treatments, including IVF, ICSI, ED, FER, PGD/PGS, IVM, IUI-H and IUI-D started between the 1 January 2005 and the 31 December 2005. Follow-up data on pregnancies and deliveries are based on those treatments carried out during the reporting period. For IUI, only pregnancies, and not deliveries, were recorded. The number of clinics reporting IUI data may differ from the number of clinics presenting data on the in vitro techniques.

The principles of reporting 2005 data are basically similar to those preceding years (ESHRE, 2001aGo, bGo, 2002Go, 2004Go, 2005Go, 2006Go, 2007Go, 2008Go).

As it is evident from the tables, registers from a number of countries have been unable to provide some of the data required. As the data presented here are incomplete and generated through different methods using partly different definitions in different countries, the data need to be interpreted with caution.


   Results
Top
 Abstract
 Introduction
 Materials and Methods
 Results
Comments
 Supplementary data
 Appendix
 References
 
Number of treatment cycles
Table I shows the number of all treatment cycles recorded in each country, the number of clinics in the country and the number of clinics reporting to the register. The cycles are subdivided into treatment modalities such as IVF, ICSI, FER, ED, IVM and PDG/PGS. In Belgium, Iceland, Lithuania and Portugal, the number of oocyte recoveries were used, as the number of initiated cycles was not available. In total, 923 clinics out of 1134 from 30 countries reported 418 111 cycles.


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  		Table I ART in European countries in 2005

 
Among the 321 403 fresh cycles, the distribution between IVF (118 074) and ICSI (203 329) was 36.7% and 63.3%, respectively. The proportion of FER cycles compared with ‘fresh’ cycles was 79 140/321 403 (24.6%).

Table II shows data from those 16 countries where all clinics have reported to the register. The number of cycles is associated with the total population in the country as well as with the number of females of reproductive age (15–49 years). Additionally, the number of infants born after ART is expressed as a percentage of the total number of live born in the country. Overall, 258 516 cycles were undertaken in a population of 274.2 million, giving a mean of 1115 cycles per million. On average, four cycles were performed per 1000 women of reproductive age. The proportion of infants born after ART in the 16 countries ranged from 0.1% to 3.9% of all live born children.


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  		Table II ART in those countries where all clinics reported to the national register in 2005

 
Size of the clinics
Table III shows the size distribution of the reporting clinics. The size of a clinic (or unit) is based on all cycles performed per year.


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  		Table III Size of the IVF clinics reporting to the register in 2005

 
The distribution of clinics according to the number of cycles provided varied considerably among the countries. Among the larger countries, it could be noted that in Italy, 44% of the clinics provided fewer than 100 cycles annually, whereas in Belgium, 44% of the clinics performed >1000 cycles a year. In the Netherlands (where satellite stimulated cycles are frequent), 77% of the clinics handling the gametes performed >1000 cycles annually.

Age distribution
Table IV shows the age distribution of those women treated with IVF or ICSI in various countries.


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  		Table IV Age distribution (years) of women treated with IVF and ICSI in 2005

 
Number of embryos transferred
Table V shows the number of embryos transferred after IVF and ICSI combined. The total number of single embryo transfers (SETs) was 47 348 (20.0%). Double embryo transfers (DET) numbered 132 683 (56.1%), triple embryo transfers 50 841 (21.5%) and four or more embryo transfers occurred in 5436 (2.3%) cycles. As indicated in this table, major differences were seen between countries. In 2005, several countries reported a large number of SETs. The highest levels were found in Sweden (69.4%), Finland (49.7%), Belgium (48.0%), Denmark (32.6%) and Slovenia (30.0%). The proportion of triple embryo transfers ranged from zero in Sweden to 50.4% in Italy. Transfer of four or more embryos ranged from 0% in several countries to 35.8% in Lithuania.


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  		Table V Number of embryos transferred after IVF and ICSI in 2005

 
Pregnancies and deliveries after treatment
Tables VI–IX show the number of pregnancies and deliveries in relation to the number of initiated cycles, aspirations and transfers for IVF (Table VI), ICSI (Table VII), FER (Table VIII) and ED (Table IX).


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  		Table VI Pregnancies and deliveries after IVF in 2005

 

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  		Table IX Pregnancies and deliveries after ED in 2005

 

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  		Table VII Pregnancies and deliveries after ICSI in 2005

 

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  		Table VIII Pregnancies and deliveries after FER (IVF and ICSI combined) in 2005

 
Table VI shows that after IVF, 29 302 pregnancies resulted from 108 769 aspirations and 96 729 embryo transfers. Thus, the mean clinical pregnancy rate was 26.9% per aspiration and 30.3% per embryo transfer.

Table VII shows that after ICSI, 55 305 pregnancies resulted from 194 156 aspirations and 179 012 transfers. Thus the mean clinical pregnancy rate was 28.5% per aspiration and 30.9% per embryo transfer.

Table VIII shows that after FER, 13 719 pregnancies resulted from 70 151 transfers. Thus the mean clinical pregnancy rate per embryo transfer after FER was 19.0%.

Table IX shows that after ED, 4576 clinical pregnancies resulted from 10 920 embryo transfers, giving a clinical pregnancy rate per transfer of 41.9%.

In Tables VI–IX, the delivery rates per embryo transfer have not been summarized due to incompleteness or absence of follow-up of pregnancies in many countries.

Singleton, twin, triplet and quadruplet deliveries
Table X shows the deliveries after IVF and ICSI in relation to singleton, twin and triplet deliveries. The distribution of the deliveries was as follows: singleton 37 487 (78.2%), twin 10 067 (21.0%) and triplet 396 (0.8%).


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  		Table X Singleton, twin, triplet and quadruplet deliveries after IVF and ICSI in 2005

 
Table XI shows deliveries after FER in relation to singleton, twin and triplet deliveries. It is shown that the distribution of the deliveries was as follows: singleton 7303 (85.6%), twin 1191 (13.9%) and triplet 38 (0.4%).


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  		Table XI Singleton, twin, triplet and quadruplet deliveries after FER in 2005

 
Preimplantation genetic diagnosis/screening
Data on PGD/PGS activity were available from 13 countries (Table I): in total PGD/PGS accounted for 5846 cycles, 4486 aspirations, 4355 embryo transfers, 1388 pregnancies (32% per transfer) and 780 deliveries.

In vitro maturation
As shown in Table I, IVM was recorded in eight countries. A total of 247 aspirations were recorded, resulting in 23 pregnancies (9% per aspiration).

Complications and fetal reductions
Table XII presents the incidence of ovarian hyperstimulation syndrome (OHSS) recorded from registers in 26 of the 30 countries. It is seen that 3347 cases of OHSS were recorded. The number of IVF and ICSI cycles in those 26 countries were 287 452, corresponding to a risk of OHSS of 1.2% of all stimulated cycles. Other complications are also shown in the table.


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  		Table XII Complications and fetal reductions in 2005

 
Table XII also shows that a total of 436 fetal reductions were recorded.

Intrauterine inseminations
Table XIII summarizes data on IUI-H stratified by female age groups <40 years (upper panel) and >40 years (lower panel). For France, no stratification for age was available, and the overall results are included in the group <40 years of age.


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  		Table XIII IUI-H in 2005

 
In women <40 years of age, 120 613 treatments resulted in 15 154 pregnancies, giving a pregnancy rate of 12.6% per procedure. In women at >40 years, the corresponding figures were 8295, 617 and 7.4%.

In women <40, singleton, twin and triplet pregnancies accounted for 87.9%, 11.0% and 1.1% of the pregnancies, respectively, whereas in women >40, the corresponding figures were 94.4%, 4.9% and 0.7%.

Table XIV gives data on IUI-D stratified by female age groups <40 years (upper panel) and 40 years or more (lower panel). For France, no stratification for age was available, and the overall results are included in the group <40 years of age.


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  		Table XIV IUI-D in 2005

 
In women <40 years of age, 18 515 treatments resulted in 3498 pregnancies giving a pregnancy rate per insemination of 18.9%. In women at 40 years or above, the corresponding figures were 2053, 189 and 9.2%.

In women <40, singleton, twin and triplet pregnancies accounted for 88.0%, 10.8% and 1.2% of the pregnancies, respectively, whereas in women >40, the corresponding figures were 93.5%, 6.5% and 0%.

Cumulative delivery and multiple delivery rates
Table XV gives an estimation of the cumulative delivery rates per initiated fresh stimulated cycle. This is not the real cumulative delivery rate per couple per cycle, but shows the number of deliveries obtained from the FER cycles added to the deliveries from the stimulated cycles during the same year. Additionally, the table shows the rate of multiple deliveries after the ‘fresh’ cycles and the FER combined.


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  		Table XV The cumulative delivery rates in fresh and frozen cycles in 2005

 

   Comments
Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Comments
Supplementary data
 Appendix
 References
 
The present report is the ninth consecutive, annual European report on ART data. Together these reports cover treatment cycles from 1997 to 2005. It can be argued that as long as data are incomplete, generated through different methods of data collection and use partly different definitions, the results should not be summarized, as occurs in this report. Therefore, the focus should primarily be on specific country data rather than on summary data.

In 2005, the number of countries reporting to ESHRE's EIM Consortium increased to 30 covering the whole of Western Europe. For 2005, Turkey contributed almost 30 000 cycles covering the majority of centres in the country. In Eastern and South Eastern Europe, no data were available from the following countries: Estonia, Latvia, Bosnia, Romania and Slovakia.

In the report from 2004, the number of cycles from Germany declined to only 57 000 cycles compared with above 102 000 cycles in 2003. The present data show that this decline, which was due to the introduction of a more restrictive re-imbursement policy, in January 2004, is still present in 2005, with the number of treatments totalling 53 000. The German example provides good evidence that a public re-imbursement policy of ART has a major impact on the number of treatments.

Overall, the number of reported ART cycles reached 418 111 in 2005, compared with 367 966 in 2004, equivalent to an increase of 13.6%. A part of this was due to inclusion of the data from the National ART register in Turkey in the present report. In addition, the present report includes data from almost 150 000 IUI cycles.

Within Europe, the largest number of ART cycles were reported from France (71 000), Germany (53 000), Spain (42 000) and the UK (42 000). This compares globally with 134 000 cycles from the USA (CDC, 2007Go) in 2005, and 51 000 cycles were reported from Australia and New Zealand in 2005 (AIHW, 2007Go).

We still do not have a complete European dataset, as the present report included data from 923 of 1134 (81%) of all centres in the reporting countries. Additionally, we believe that those clinics that do not report are likely to be smaller in size than those that do report. In Greece, only 16 of 49 clinics report, but efforts are being made to establish a statutory register. As shown in Table I, the number of reporting clinics in Italy (177/194) and Spain (131/184) has increased considerably. Expansion of reporting in Italy can be explained by the fact that reporting became mandatory in 2004. It should be noted that the proportion of clinics reporting IUI may differ considerably from the number reporting on ART.

As shown in Table II, the average number of treatment cycles per million inhabitants was 1115 with a range from 46 in Albania to 2209 in Denmark. Another way to define the availability of ART is that four treatment cycles were done per 1000 women of reproductive age (15–49 years).

The proportion of ICSI versus standard IVF procedures continued to increase (49% in 2001; 52% in 2002; 55% in 2003; 59% in 2004 and 63% in 2005). A similar trend has been observed in the USA (Jain and Gupta, 2007Go). As recently reviewed, the trend towards increased use of ICSI has been observed throughout the world (Nyboe Andersen et al., 2008Go). In Australia and New Zealand, 58.5% of all cycles used ICSI in 2005 and in the USA, the corresponding figure was 59.6%, so there is a very uniform development in those three regions. However, within Europe there is a marked regional variation in terms of the ratio between IVF and ICSI. As can be seen in Table I, certain countries, such as Belgium (75.0%), Germany (70.2%), Italy (72.9%), Spain (83.4%) and Turkey (97.2%), use ICSI very frequently. In the Nordic countries, the Netherlands, Russia and the UK, IVF remains the dominant technology. As recently analysed, the marked increase in the use of ICSI cannot be explained by a similar increase in male infertility but rather to a more frequent use of ICSI in cases with mixed causes of infertility, unexplained infertility and mild male factor infertility. This is however unlikely to explain the striking differences between countries, which can only be explained by professional preference (Nyboe Andersen et al., 2008Go).

This report also demonstrates that the number of embryos transferred in IVF and ICSI cycles differed substantially between countries, but there is a clear trend towards transfers with fewer embryos (Table V). The mean percentage of SETs increased from 12.0% in 2001 to 13.7% in 2002, 15.7% in 2003, 19.1% in 2004 and 20.0% in 2005. The proportion of DET increased by 1% since 2004, and the proportion of three (21.5%) and four (2.3%) embryo transfers continued to decrease in 2005. In conclusion, the trend towards reduction in the number of embryos transferred continued in 2005.

This report is unable to discriminate between the numbers of elective SET (eSET) versus SET, but the rise in the number of one embryo transfers is undoubtedly due to enhanced rate of eSET. As seen in Table V, there were six countries that reported transfer of a single embryo in >25% of all transfers: Sweden (69.4%), Finland (49.7%), Belgium (48.0%), Norway (42.8%), Denmark (32.6%) and Slovenia (30.0%). For comparison, SET was done in 48.2% of cycles in Australia and New Zealand (AIHW, 2007Go).

The consistent trend towards transfer of fewer embryos is also reflected in the overall occurrence of multiple deliveries after IVF and ICSI. In 2000, the average multiple delivery rate was 26.9%, declining to 25.5% in 2001, 24.5% in 2002, 23.1% in 2003, 22.7% in 2004 and 21.8% in 2005. During the 9 year period of EIM reporting, the most remarkable finding regarding multiple births has been the reduction in triplet deliveries from 3.6% in 1997, to 2.3% in 1998, 2.3% in 1999, 1.9% in 2000, 1.5% in 2001, 1.3% in 2002, 1.1% in 2003, 1.0% in 2004 and 0.8% in 2005. As it is evident from Table X, however, huge differences in triplet rates are still found between countries.

Fetal reductions are only done in extraordinary cases in twin gestations, but when analysing the range of triplet delivery rates in different countries, the number of fetal reductions should also be considered. A total of 436 procedures were reported, the largest numbers coming from Spain (107), the UK (99), France (62) and Greece (46). It is worth noting that although a number of countries did not report on fetal reductions, the number reported was higher than the reported number of triplet deliveries. Without fetal reductions, the proportion of triplet deliveries would indeed have been higher.

Pregnancy rates for IVF, ICSI and FER were marginally increased compared with 2004. For IVF, the mean pregnancy rate per transfer was 30.3% compared with 30.1% in 2004. For ICSI, the mean pregnancy rate per transfer reached 30.9% compared with 28.9% in 2004. For FER, it was unchanged at 19.6%.

The pregnancy rates in Europe remain lower than in the USA where 42.0% of transfers from non-donor cycles resulted in a pregnancy. In thaw cycles, the live birth rate was as high as 27.3% (CDC, 2007Go). However, the pregnancy rates in Europe are very similar to what is achieved in Australia and New Zealand, where the clinical pregnancy rate per transfer was 30.6% after fresh cycles and 21.5% after FER transfers in 2005 (AIHW, 2007Go).

The data on pregnancy and delivery rates presented so far in the EIM reports represent overall results for women in all age groups. At the EIM Consortium meeting in Barcelona, July 2008, it was decided to collect European data in a way that would permit stratification of the pregnancy and delivery rates in relation to age groups.

With a noticeable decline in the number of embryos transferred, the cumulative delivery rate per started cycle may be a most relevant end-point for ART. Table XV gives a calculation of cumulative delivery rates, but it should be stressed that this does not represent the true cumulative delivery rate per cycle and per couple, and only gives an estimate based on fresh and FER cycles done during the same year. In a steady state situation, this calculation will give a rather good estimate of the true cumulative delivery rate. In several countries, the addition of FER deliveries have resulted in a substantial increase in the delivery rates per cycle: Finland (21.3% to 31.6%), Sweden (24.7% to 31.5%) and Switzerland (24.7% to 32.5%).

PGD/PGS activity was recorded from 13 countries and included 5846 cycles resulting in 1388 pregnancies (32% per transfer). Detailed reporting of PGD/PGS in Europe is published separately by ESHRE's PGD Consortium. The last report deals with data from 2005 (Goossens et al., 2008Go).

With respect to direct risks of ART, OHSS was recorded in 1.2% of cycles. This was similar to figures in the preceding years and seems to argue against an increased use of mild stimulation protocols in Europe.

For the fourth consecutive year, the present report includes European data on treatments with IUI-H (129 000 cycles) and IUI-D (21 000 cycles). The coverage of IUI activities by the national registers is much less comprehensive than for the in vitro techniques. In women <40 years of age, the pregnancy rate was 12.6% for IUI-H and 18.9% for IUI-D.

After IUI-H in women <40 years of age, twin pregnancies occurred in 11.0% and triplet pregnancies in 1.1%, still only half of what is found after the in vitro techniques, but with similar triplet rates.

In summary, the present ninth ESHRE report on ART for Europe in 2005 shows a continuing expansion of numbers of participating clinics, countries and treatment cycles reported. The rise in the use of ICSI has continued to the point where is reached 63.3% in 2005. Pregnancy rates after IVF and ICSI were marginally increased compared with 2004, but fewer embryos were transferred per cycle and the overall SET reached 20% in 2005. As a consequence, the multiple delivery rates have continued to decline to 21.8% of all deliveries after IVF and ICSI.


   Supplementary data
Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Comments
 Supplementary data
Appendix
 References
 
Supplementary data including a list of all European clinics that participated in the data collection are available at http://humrep.oxfordjournals.org.


   Appendix
Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Comments
 Supplementary data
 Appendix
References
 
EIM Committee: Chairman, A.N.A.; Chairman elect, J.M.; Past chairman K.G.N.; Members, S.B., M.S.K., A.P.F. V.G. is Science Manager at ESHRE Central Office, Brussels. See also Supplementary Appendix for contributing centres and contact persons representing the data collection programmes in the participating European countries.

Contact persons representing data collection programmes in participating European countries, 2005

Albania
Prof. Orion Glozheni, University Hospital for Obstetrics and Gynecology, Bul. B. Curri, Tirana, Albania. Tel: +355-4-235-870; Fax: +355-4-257-688; Mobile: +355-68-20-29313; E-mail: gliorion{at}icc-al.org.

Belgium
Dr Michel Candeur, ULB, Politiques et systèmes de santé, 808, Route de Lennik, 1070 Brussels, Belgium. Tel: +32-2-555-40-90; Fax: +32-2-555-40-49; Mobile: +32-475-73-78-26; E-mail: michel.candeur{at}ulb.ac.be.

Bulgaria
Prof. Stanimir Kyurkchiev, Inst. Biology & Immunology of Reproduction, Molecular Immunology, 73, Tzaritgradsko shosse, 1113 Sofia, Bulgaria. Tel.: +359-(2)723-890; Fax: +359-(2)720-925; E-mail: skyurchiev{at}mail.bg.

Croatia
Dr Branko Radakovic, Human Reproduction Unit, University Gynaecologic Clinic, Pertova 13, 10 000 Zagreb, Croatia. Tel:+385-1-460-47-21; Fax: +385-1-460-46-46; E-mail: branko.radakovic{at}zg.htnet.hr.

Czech Republic
Dr Karel Rezabek, Charles University Prague, Gynecology and Obstetrics Department, Apolinarska 18, 12 000 Prague, Czech Republic. Tel: +420224096074018; E-mail: karel.rezabek{at}vfn.cz.

Denmark
Dr Karin Erb, Fertility Clinic, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark. Tel: +45-65-41-23-24; Fax: +45-65-90-69-82; E-mail: karin.erb{at}ouh.regionsyddanmark.dk.

Finland
Dr Aila Tiitinen, Helsinki University Central Hospital, Department of Obstetrics and Gynecology, PO Box 140, 00 029 Hus-Helsinki, Finland. Tel: +385-5-04-27-12-17; Fax: +385-9-47-17-48-01; E-mail: aila.tiitinen{at}hus.fi.

France
Dr Jacques De Mouzon, INSERM U U569, 82, Rue Général Leclerc, 94276 Le Kremlin-Bicêtre Cedex, France. Tel: +33-1-4521-2338; Fax: +33-1-4521-2075; Mobile: +33-6-62-06-22-74; E-mail: demouzon{at}vjf.inserm.fr.

Dr Taraneh Shojaei, Agence de la Biomédecine, 1 Av du stade de France. Tel: +33-1-55-93-64-02; E-mail: taraneh.shojaei{at}biomedecine.fr.

Germany
Dr Klaus Bühler, Center for Gynaecology, Endocrinology and Reproductive Medicine, Ostpassage 9, 30 853 Langenhagen, Germany. Tel: +49-511-97230-40; Fax: +49-511-97230-18; E-mail: k.buehler{at}kinderwunsch-langenhagen.de.

Greece
Prof. Dr Basil Tarlatzis, Geniki Kliniki, Infertility and IVF Centre, 2 Gravias Street, 54 645 Thessaloniki, Greece. Tel: +30-231-08-66-477/08-21-681; Fax: +30-231-08-21-420; Mobile: +30-694-431-53-45; E-mail: tarlatzis{at}hol.gr.

Hungary
Prof. Janos Urbancsek, Semmelweis University, 1st Department of Obstetrics and Gynecology, Baross utca 27, 1088 Budapest, Hungary. Tel: +36-1-266-01-15; Fax: +36-1-266-01-15; E-mail: urbjan{at}noi1.sote.hu.

Iceland
Mr. H. Bjorgvinsson, Art Medica, IVF Unit, Baejarlind 12, 201 Kopavogur, Iceland. Tel: +354-515-8100; Fax: +354-515-8103; E-mail: hilmar{at}artmedica.is.

Ireland
Dr Edgar Mocanu, HARI Unit, Rotunda Hospital, Dublin 1, Ireland. Tel: +35-31-8072-732; Fax: +35-31-8727-831; E-mail: emocanu{at}rcsi.ie.

Italy
Dr Guilia Scaravelli, Registro Nazionale Medicalmente Assistita, CNESPS, Instituto Superiore de Sanita, Viale Regina Elena, 299, 00161, Roma. Tel: +39-49904317; Fax: +39-49904324; E-mail: guilia.scaravelli{at}iss.it.

Latvia
Dr Voldemars Lejins, EGV Clinic, Department of IVF, Gertrudes Str. 3, LV 1010 Riga. Tel: +371-7-27-81-83; Fax: +371-7-31-64-67; E-mail: egv{at}apollo.lv.

Lithuania
Dr Zivile Gudleviciene, Fertility Centre, IVF Laboratory, Mairono 25, 01125 Vilnius, Lithuania. Tel: +370-52614226; Fax: +370-52614226; E-mail: zivile.g.udleviciene{at}gmail.com.

Macedonia
Dr Slobodan Lazarevski, SHOG ‘Mala Bogorodica’, Londonska 19, 1000 Skopje, Macedonia. Tel: +389-2-30-73-335; Fax: +389-2-30-73-398; Mobile: +389-70-246-089; E-mail: dr.lazarevski{at}mbogorodica.com.mk.

Montenegro
Dr Tatjana Motrenko Simic, I Proleterska S 53/II, 85310 Budva, Montenegro. Tel: +381-69052331; Fax: +381-86452033; Email: motrenko{at}cg.yu.

The Netherlands
Dr Cornelis Lambalk, Free University Hospital, Reproductive Medicine, de Boelaan 1117, PO Box 7057, 1007 MB Amsterdam, The Netherlands. Tel: +31-20-444-00-70; Fax: +31-20-444-00-45; E-mail: cb.lambalk{at}vumc.nl.

Norway
Dr Johan T. Hazekamp, Volvat Medisinske Senter, A.S., PO Box 5280 Majorstua, 0303 Oslo, Norway. Tel: +47-22-95-75-00; Fax: +47-22-93-24-02; E-mail: johan.hazekamp{at}volvat.no.

Poland
Mr Waldemar Kuczynski, Medical Akademy I, Department of Obstetrics and Gynecology, Sklodowska 24a, 15-276 Bialystok, Poland. Tel: +48-502-273-923; Fax: +48-85-744-13-78; E-mail: kuczynsk{at}pb.bialystok.pl.

Portugal
Prof. Dr Carlos Calhaz-Jorge, Human Reproduction Unit, Department of Obstetrics and Gynecology, Hospital de Santa Maria, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal. Tel: +351-21-72-64-229; Fax: +351-21-78-05-621; E-mail: calhazjorge{at}mail.telepac.pt.

Russia
Dr Vladislav Korsak, International Center for Reproductive Medicine, Head of IVF Centre, Mendeleyevskay Liniya 3, Vasilievsky Island, 199034 St-Petersburg, Russia C.I.S. Tel: +7-812-328-2251; Fax: +7-812-328-22-51; Mobile: +7-921-965-19-77; E-mail: korsak{at}mcrm.ru.

Serbia
Prof. Nebosja Radunovic, Institute for Obstetrics and Gynecology, Visegradska 26, 11000 Belgrade, Serbia. Tel: +38-163200204; Fax: +38-1113615603; E-mail: radunno1{at}med.nyu.edu or radunno{at}gmail.com.

Slovakia
Dr Ladislav Marsik, Iscare, Sulekova 20, 811 06 Bratislava, Slovakia. Tel: +42-1-905-251-904; E-mail: laco{at}marsik.sk.

Slovenia
Dr Tomaz Tomazevic, University Medical Centre Ljubljana, Obstetrics and Gynecology Reproduction, Slajmerjeva 3, 61 000 Ljubljana, Slovenia. Tel: +386-1-522-60-60; Fax: +386-1-439-75-90; E-mail: tomaz.tomazevic{at}guest.arnes.si.

Spain
Dr Juana Hernandez, Hospital San Millan, Servicio de Ginecologia y Obstetricia, Avda. Autonoma de la Rioja 3, 26 001 Logrono, Spain. Tel: +34-94-12-73-077; Fax: +34-94-12-73-081; E-mail: jhernandezh{at}telefonica.net.

Sweden
Dr Per-Olof Karlcstrom, Akademiska Hospital, Department of Obstetrics and Gynecology, 751 85 Uppsala, Sweden. Tel: +46-611-2838; Fax: +46-211-31611; E-mail: pok.red{at}swipnet.se.

Switzerland
Ms Maya Weder, Administration FIVNAT, Postfach 89, 3122 Kehrsatz, Switzerland. Tel: +41-31-819-76-02; Fax: +41-31-819-89-20; E-mail: administration.sgrm{at}bluewin.ch.

Turkey
Dr Mete Isikoglu, Ozel Antalya Tup Bebek Merkezi, Antalya IVF Center, Tup Bebek, Halide Edip cad. No:7, 07 080 Antalya, Turkey. Tel: +90-242-3454700; Fax: +90-242-3454700; E-mail: misikoglu{at}gmail.com.

Ukraine
Dr Viktor Veselovsky, Isida IVF Clinic Gynaecology Dept. Lepse 6, 03 126 Kyiv, Ukraine. Tel: +380-44-25-12-101; Fax: +380-44-25-12-108; E-mail: v.veslovskyy{at}ivf.com.ua.

UK
Mr Richard Baranowski, Deputy Information Manager, Human Fertilization and Embryology Authority (HFEA), 21 Bloomsbury Street, London WC1B 3HF, UK. Tel: +44-20-7539-3329; Fax: +44-20-7377-1871; E-mail: richard.baranowski{at}hfea.gov.uk.


   Footnotes
 
{dagger} EIM Committee members are listed in the Appendix. Back


   References
Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Comments
 Supplementary data
 Appendix
 References
 
AIHW, Australian Institute of Health and Welfare. Assisted Reproduction Technology in Australia and New Zealand 2005. In: Assisted Reproduction Technology Series, Number 11 (2007) National Perinatal Statistical Unit and Fertility Society of Australia.

CDC, Centres for Disease Control and Prevention. Reproductive Health. Assisted Reproductive Technology. National Summary and Fertility Clinic Reports (October 2007, last date accessed).

ESHRE. The European IVF-monitoring programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE). Assisted reproductive technology in Europe, 1997. Results generated from European registers by ESHRE. Hum Reprod (2001) a 16:384–391.[Abstract/Free Full Text]

ESHRE. The European IVF monitoring programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE). Assisted reproductive technology in Europe, 1998. Results generated from European Registers by ESHRE. Hum Reprod (2001) b 16:2459–2471.[Abstract/Free Full Text]

ESHRE. The European IVF monitoring programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE). Assisted reproductive technology in Europe, 1999. Results generated from European Registers by ESHRE. Hum Reprod (2002) 17:3260–3274.[Abstract/Free Full Text]

ESHRE. The European IVF monitoring programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE). Assisted reproductive technology in Europe, 2000. Results generated from European Registers by ESHRE. Hum Reprod (2004) 19:490–503.[Abstract/Free Full Text]

ESHRE. The European IVF monitoring programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE). Assisted reproductive technology in Europe, 2001. Results generated from European Registers by ESHRE. Hum Reprod (2005) 20:1158–1176.[Abstract/Free Full Text]

ESHRE. The European IVF monitoring programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE). Assisted reproductive technology in Europe, 2002. Results generated from European Registers by ESHRE. Hum Reprod (2006) 21:1680–1697.[Abstract/Free Full Text]

ESHRE. The European IVF monitoring programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE). Assisted reproductive technology in Europe, 2003. Results generated from European Registers by ESHRE. Hum Reprod (2007) 22:1513–1525.[Abstract/Free Full Text]

ESHRE. The European IVF monitoring programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE). Assisted reproductive technology in Europe, 2004. Results generated from European Registers by ESHRE. Hum Reprod (2008) 23:756–771.[Abstract/Free Full Text]

Goossens V, Harton G, Moutou C, Scriven PN, Traeger-Synodinos J, Sermon K, Harper J. ESHRE PGD Consortium data collection VIII: cycles from January to December 2005 with pregnancy follow-up to October 2006. Hum Reprod (2008) 23:2629–2645.[Abstract/Free Full Text]

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Submitted on December 15, 2008; resubmitted on December 15, 2008; accepted on January 6, 2009.


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