Lightning Talk + Poster ESA-SRB-ANZBMS 2024 in conjunction with ENSA

Three decades of assisted reproductive technologies: global trends and shifts to combat poor oocyte quality (#413)

Alexandra E Peters 1 2 , Shaun D Roman 3 , Elizabeth G Bromfield 4 5 6 , Brett Nixon 5 6 , Eileen A McLaughlin 7 , Kirsty G Pringle 1 2 , Jessie M Sutherland 1 2
  1. School of Biomedical Science and Pharmacy, College of Health, Medicine, and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
  2. Centre for Women's Health Research, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
  3. NSW Health Pathology, Newcastle, NSW, Australia
  4. School of BioSciences, Faculty of Science, Bio21 Institute, The University of Melbourne, Parkville, VIC, Australia
  5. School of Environmental and Life Sciences, College of Engineering, Science, and Environment, University of Newcastle, Callaghan, NSW, Australia
  6. Infertility and Reproduction Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
  7. Faculty of Science, Medicine, and Health, University of Wollongong, Wollongong, NSW, Australia

Infertility is a global health problem affecting 1 in every 6 people, and to overcome this, assisted reproductive technologies (ARTs) are increasingly employed. Oocyte quality is a crucial factor underpinning ART success which diminishes with advancing age and environmental exposures. Current ARTs cannot discern ‘good’ oocytes or improve ‘bad’ or poor-quality oocytes, limiting success. This study examined 30 years of global ART data, focusing on trends concerning oocyte quality: oocyte/embryo cryopreservation and advanced maternal age.

Clinical data was extracted from annual ART reports with >20 years of consistent, publicly available data from Australia, New Zealand, Canada, Europe, Japan, Latin America, United Kingdom, and United States (66 countries total). Total ART cycles, oocyte/embryo cryopreservation, fresh and frozen cycles, and ART uptake and success in >35-year-old females were analysed.

Assessment of international trends revealed ART uptake soared between 1991-2021, going from 3 to 24.6 cycles/10,000 inhabitants across all countries. From 2010-2021, oocyte/embryo cryopreservation rates increased rapidly, from 6.7 to 30.2% of cycles performed. Concurrently, performance of frozen cycles (using cryopreserved oocytes/embryos) increased to comprise 42% of procedures in 2021, dominating ART methods globally, while fresh cycles plummeted from 78% in 2001 to 22% in 2021. Females >35-years-old remained the primary patient demographic across 20 years; constituting 60-70% of fresh and 50-60% of frozen cycles. During this time, fresh cycle live birth rates in >35-year-olds remained low (12.5-17.6%), while frozen cycle live birth rates improved to 20.2-27.4%, surpassing fresh cycle success.

These findings highlight the enormous growth of ART uptake globally, particularly in adoption of oocyte/embryo cryopreservation and frozen cycles. Paired with improved frozen success rates in >35-year-olds, these data illustrate the shifts made to overcome the biological limitations of oocyte quality. This analysis provides critical information towards the development of strategies to design, monitor, and forecast industry practices to improve ART success.