FIVNAT-CH. Annual report 2002

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1 FIVNAT-CH Schweizerische Gesellschaft für Reproduktionsmedizin Annual report 2002 Date of analysis Source: FileMaker Pro files FIVNAT_CYC.FP5 and FIVNAT_PAT.FP5

2 SUMMARY TABLE SUMMARY RESULTS P ARTICIPATING C ENTRES AND T REATMENT C YCLES...3 D ISTRIBUTION OF N UMBER OF C YCLES PER P ATIENT...3 M AIN RESULTS F RESH CYCLES...4 M AIN RESULTS C RYO CYCLES...4 FIVNAT-CH EVOLUTION OF INITIATED CYCLES BY TECHNIQUE ( )... 5 EUROPE INITIATED CYCLES BY TECHNIQUE FIVNAT-CH SIZE OF CLINICS EUROPE SIZE OF CLINICS 2000 (IN % OF ALL CLINICS)... 8 FIVNAT-CH AGE OF WOMEN (FRESH CYCLES)... 9 EUROPE AGE DISTRIBUTION OF TREATED WOMEN EUROPE EMBRYOS TRANSFERRED IN IVF AND ICSI FRESH CYCLES EUROPE PREGNANCY RATES AFTER IVF FRESH CYCLES EUROPE PREGNANCY RATES AFTER ICSI FRESH CYCLES EUROPE PREGNANCY RATES AFTER FER FIVNAT-CH PREGNANCY RATES BY WOMAN S AGE 2002 FRESH CYCLES FIVNAT-CH PREGNANCY RATES BY WOMAN S AGE 2002 CRYO CYCLES FIVNAT-CH PREGNANCY RATE BY NO. OF TRANSFERRED EMBRYOS IN FIVNAT-CH PREGNANCY RATE BY DAY OF TRANSFER 2002 (FRESH CYCLES) FIVNAT-CH DAY OF TRANSFER, NO. OF TRANSFERRED EMBRYOS AND MULTIPLE PREGNANCIES ( ) EUROPE SINGLETONS, TWINS AND TRIPLETS DELIVERIES RESULTS 2002 AFTER IVF AND ICSI FRESH CYCLES RESULTS 2002 AFTER CRYOPRESERVED EMBRYO TRANSFERS RESULTS 2002 BY WOMAN S AGE - FRESH CYCLES RESULTS 2002 BY WOMAN S AGE - CRYO CYCLES RESULTS 2002 BY NO. OF TRANSFERRED EMBRYOS FRESH CYCLES RESULTS 2002 BY NO. OF TRANSFERRED EMBRYOS - CRYO CYCLES RESULTS 2002 BY DAY OF TRANSFER AFTER FRESH CYCLES... 26

3 SUMMARY RESULTS 2002 PARTICIPATING CENTRES AND TREATMENT CYCLES EVOLUTION 2002/2001 PARTICIPATING CENTRES AVAILABLE CENTRES TREATMENT CYCLES FRESH CRYO % +10.2% TOTAL % NUMBER OF PATIENTS % AVERAGE CYCLES PER PATIENT 1.6 same The increase in the number of initiated cycles is mainly due to cryo cycles (+10.2%). Fresh cycles increased in 2002 only by 0.9%. The number of centres has increased from 18 to 20. DISTRIBUTION OF NUMBER OF CYCLES PER PATIENT CYCLES PER PATIENT 2002 Frequency Percent % % % % The distribution of cycles per patient, where 63.4% of the patients underwent one cycle, is the same as in 2001.

4 MAIN RESULTS FRESH CYCLES FIVNAT-CH STATISTICS 2002 Fresh cycles IVF ICSI TOTAL Cycles initiated % by technique 31.5% 68.5% 100.0% Biochemical pregnancies Clinical pregnancies % of Initiated cycles 24.2% 24.6% 24.4%...% of OPU cycles 27.0% 25.7% 26.1%...% of Transfer cycles 29.9% 27.6% 28.3% Implantation rate (%) 17.6% 15.1% 15.8% Detailed results for fresh cycles are shown on page 24, comparisons with reference countries on page MAIN RESULTS CRYO CYCLES FIVNAT-CH STATISTICS Cryo cycles Technique unknown 2002 IVF ICSI TOTAL Initiated cycles % by technique 1.3% 30.4% 68.2% 100.0% Biochemical pregnancies Clinical pregnancies % of Initiated cycles 10.3% 16.6% 16.0% 16.1%...% of Transfer cycles 13.6% 17.9% 17.4% 17.6% Implantation rate (%) 6.0% 10.0% 10.5% 10.3% Detailed results for cryo cycles are shown on page 25, comparisons with reference countries on page 15. Pregnancy rates in 2002 are significantly better than in 2001: for fresh initiated cycles they reach 24.4% (2001: 20.6%) and for cryo cycles 16.1% (2001: 14.3%). These rates are comparable to those observed in Europe 1. The mean age of the FIVNAT-CH women is nevertheless higher (see page 11, Age structure of treated women in Europe). 1 ESHRE Report 2000

5 FIVNAT-CH EVOLUTION OF INITIATED CYCLES BY TECHNIQUE ( ) Year Technique IVF Fresh ICSI Fresh TOTAL FRESH IVF Cryo ICSI Cryo TOTAL CRYO * TOTAL *29 initiated cycles without known technique not considered in the table for the year 2002.

6 EUROPE INITIATED CYCLES BY TECHNIQUE 2000 Country Technique IVF % ICSI % FER % FIVNAT CH Belgium Germany France Netherlands Sweden Source: Eshre Report Results 2000 and FIVNAT-CH, in some cases percent values do not add up to 100% due to rounding. In 2002 the distribution of cycles by technique is different for FIVNAT-CH with respect to some reference ESHRE countries: the proportion of cryo cycles in Switzerland is 40.4%, almost twice the proportion observed in Belgium 2. The proportion of IVF fresh cycles is also significantly lower in Switzerland (18.7%) with respect to all other countries considered as reference. 2 Data concern the year 200

7 FIVNAT-CH SIZE OF CLINICS 2002 Size in % of all Clinics (2002) <100 cycles cycles cycles cycles >1000 cycles FIVNAT-CH 02 in % 25% 20% 40% 10% 5% Frequency

8 EUROPE SIZE OF CLINICS 2000 (IN % OF ALL CLINICS) Country -100 cycles cycles Size in % of all Clinics cycles cycles >1000 cycles FIVNAT CH 02* 25% 20% 40% 10% 5% France 6% 7% 32% 41% 15% Germany 16% 11% 28% 24% 21% Netherlands 0% 8% 0% 46% 46% Sweden 13% 0% 20% 47% 20% UK 9% 23% 27% 32% 9% Source: Eshre Report Results 2000 and FIVNAT-CH,, in some cases percent values do not add up to 100% due to rounding. *Switzerland 2002 In 2002 the distribution of cycles by centres is different for FIVNAT-CH with respect to some reference ESHRE countries: the proportion of large centres is significantly higher in the countries considered as reference.

9 FIVNAT-CH AGE OF WOMEN (FRESH CYCLES) Technique Year IVF ICSI NR ALL NR=not relevant From 1993 to 2002 the mean age of treated women has significantly increased (almost 2 years) from 33.9 to 35.7 years for IVF fresh cycles and from 33.3 to 34.6 (almost 1.5 years) years for ICSI fresh cycles.

10 EUROPE AGE DISTRIBUTION OF TREATED WOMEN Country Percentage age distribution of women treated with IVF and ICSI France Germany Sweden UK Finland Switzerland Switzerland Source: Eshre Report Results 2000 and FIVNAT-CH 62% of women treated by FIVNAT-CH Clinics in 2002 are aged 35 years or more. This is the largest proportion among the countries shown. 9% of women treated by FIVNAT-CH Clinics are aged 29 years or less. This is the smallest proportion among the countries shown.

11 EUROPE EMBRYOS TRANSFERRED IN IVF AND ICSI FRESH CYCLES No of embryos transferred in % Country Belgium Finland France Germany Sweden UK Switzerland Switzerland Source: Eshre Report Results 2000 and FIVNAT-CH The distribution of transferred embryos in Switzerland is similar to that in the reference countries.

12 EUROPE PREGNANCY RATES AFTER IVF FRESH CYCLES Country Pregnancy rate per cycle Pregnancy rate per OPU Pregnancy rate per transfer NL France Germany UK Sweden CH CH Source: Eshre Report Results 2000 and FIVNAT-CH

13 EUROPE PREGNANCY RATES AFTER ICSI FRESH CYCLES Country Preg. rate per cycle Preg. rate per OPU Preg. rate per transfer NL France Germany UK Sweden CH CH Source: Eshre Report Results 2000 and FIVNAT-CH Page 13

14 EUROPE PREGNANCY RATES AFTER FER Country Pregnancy rate per OPU Pregnancy rate per transfer NL NA 20.2 France Germany UK Sweden CH CH Source: Eshre Report Results 2000 and FIVNAT-CH FIVNAT-CH 2002: 94% of transfers (90% of the clinical pregnancies) originate from OPU carried out in 1999 and after. Page 14

15 FIVNAT-CH PREGNANCY RATES BY WOMAN S AGE 2002 FRESH CYCLES FIVNAT-CH PREGNANCY RATES BY WOMAN S AGE 2002 CRYO CYCLES Page 15

16 FIVNAT-CH PREGNANCY RATE BY NO. OF TRANSFERRED EMBRYOS IN 2002 The pregnancy rate is highly correlated with the number of transferred embryos In 2002 there were 683 transfers concerning 3 embryos for fresh cycles (25% of all fresh transfers) and 265 for cryo cycles (13.7% of all cryo transfers). Page 16

17 FIVNAT-CH PREGNANCY RATE BY DAY OF TRANSFER 2002 (FRESH CYCLES) The pregnancy rate is significantly higher when the transfer is done after 4 or more days. 106 transfers were done after 4 or more days (4% of all transfers, see page 26). Page 17

18 FIVNAT-CH DAY OF TRANSFER, NO. OF TRANSFERRED EMBRYOS AND MULTIPLE PREGNANCIES ( ) FIVNAT-CH STATISTICS (Fresh cycles) 2 days 3 days 4+ days No. of embryos transferred No. of embryos transferred No. of embryos transferred Cycles initiated % by No of embryos 11.9% 66.8% 21.4% 15.4% 48.4% 36.2% 11.4% 52.4% 36.2% Biochemical pregnancies Clinical pregnancies % of Transfer cycles 12.1% 28.3% 29.9% 6.9% 22.3% 24.8% 13.7% 31.0% 32.9% Implantation rate (%) 12.3% 16.9% 13.2% 7.4% 12.6% 11.3% 13.7% 20.9% 14.7% Singleton...% of clinical pregnancies 98.9% 78.5% 71.9% 93.5% 86.5% 67.4% 88.9% 63.7% 62.9% Multiple pregnancy...% of clinical pregnancies 1.1% 21.5% 28.4% 6.5% 13.8% 32.6% 11.1% 36.3% 37.1% When considering the time period , it appears that there is a dependency between the multiple pregnancy rate and the day of transfer, adjusting for the number of transferred embryos. The multiple pregnancy rate is 28.4% when 3 embryos are transferred after 2 days and increases to 32.6% and 37.1% after 3 days and 4 or more days, for the same number of transferred embryos. Conversely, the number of singletons decreases therefore from 71.9% after 2 days to 62.9% after 4 or more days, when 3 embryos are transferred. Page 18

19 EUROPE SINGLETONS, TWINS AND TRIPLETS DELIVERIES 2000 Singleton, twin and triplet Deliveries after ICSI and IVF (% of all deliveries) Singletons Twins Triplets Finland France Germany Sweden Switzerland Switzerland UK Source: Eshre Report 2000 and FIVNAT-CH Page 19

20 RESULTS 2002 AFTER IVF AND ICSI FRESH CYCLES 2002 FIVNAT-CH STATISTICS (Fresh cycles) IVF ICSI TOTAL Cycles initiated % by technique 31.5% 68.5% 100.0% Age woman... Mean Median Q Q Oocyte pick-up (OPU) % of initiated cycles 89.7% 95.7% 93.8% Transfers % of initiated cycles 81.0% 89.0% 86.5%...% of OPU cycles 90.3% 93.0% 92.2% Transfers with donor'sperm % of Initiated cycles 4.3% 0.4% 1.6% Oocytes collected Oocytes inseminated/injected Zygotes 2PN obtained (1) % of inseminated oocytes 60.2% 64.9% 63.4% Cleaved embryos Frozen zygotes (2) Frozen embryos (3) Embryos/Oocytes transferred (4) Embryos not used=1-(2+3+4) % of Zygotes 2PN 3.9% 4.3% 4.2% Biochemical pregnancies Clinical pregnancies % of Initiated cycles 24.2% 24.6% 24.4%...% of OPU cycles 27.0% 25.7% 26.1%...% of Transfer cycles 29.9% 27.6% 28.3% Implantation rate (%) 17.6% 15.1% 15.8% 3 In 2001 there were 97 frozen embryos, 816 in 2000, 801 in Embryos not transferred nor frozen, unknown reason Page 20

21 RESULTS 2002 AFTER CRYOPRESERVED EMBRYO TRANSFERS 2002 FIVNAT-CH STATISTICS (Cryo cycles) NA IVF ICSI TOTAL Initiated cycles % by technique 1.3% 30.4% 68.2% 100.0% Age woman... Mean Median Q Q Oocyte pick-up (OPU) Transfers % of initiated cycles 75.9% 92.7% 91.6% 91.7% Transfers with donor's sperm % of Transfer cycles 0.0% 0.2% 0.0% 0.1% Thawed zygotes Thawed embryos Embryos transferred Biochemical pregnancies Clinical pregnancies % of Initiated cycles 10.3% 16.6% 16.0% 16.1%...% of Transfer cycles 13.6% 17.9% 17.4% 17.6% Implantation rate (%) 6.0% 10.0% 10.5% 10.3% 5 30 frozen embryos in 2002, 14 in 2001, 18 in 2000, 10 in 1999, 4 in 1998, 2 in 1997 and 23 with unknown date. Page 21

22 RESULTS 2002 BY WOMAN S AGE - FRESH CYCLES FIVNAT-CH STATISTICS < 29 years years years > 40 years (Fresh cycles) IVF ICSI IVF ICSI IVF ICSI IVF ICSI Cycles initiated % by technique 27.0% 73.0% 26.0% 74.0% 31.8% 68.2% 40.8% 59.2% Oocyte pick-up (OPU) % of initiated cycles 84.0% 95.1% 92.4% 96.1% 91.5% 96.2% 89.1% 94.3% Transfers % of initiated cycles 73.3% 86.7% 83.9% 90.7% 83.5% 88.5% 81.2% 86.8%...% of OPU cycles 87.3% 91.2% 90.8% 94.4% 91.3% 92.0% 91.1% 92.0% Transfers with donor's sperm % of Initiated cycles 1.3% 0.5% 4.5% 0.8% 6.4% 0.2% 3.0% 0.3% Oocytes collected Oocytes inseminated/injected Zygotes 2PN obtained (1) % of inseminated oocytes 54.9% 62.5% 61.7% 64.8% 60.9% 65.1% 59.0% 66.3% Cleaved embryos Frozen zygotes (2) Frozen embryos (3) Embryos/Oocytes transferred (4) Embryos not used=1-(2+3+4) % of Zygotes 2PN 2.5% 3.0% 4.7% 4.5% 3.4% 4.4% 3.7% 4.1% Biochemical pregnancies Clinical pregnancies % of Initiated cycles 34.7% 27.1% 26.8% 27.8% 28.5% 24.2% 13.9% 18.7%...% of OPU cycles 41.3% 28.5% 29.0% 29.0% 31.1% 25.1% 15.6% 19.8%...% of Transfer cycles 47.3% 31.3% 31.9% 30.7% 34.1% 27.3% 17.1% 21.5% Implantation rate (%) 34.5% 21.1% 18.5% 17.8% 20.3% 13.9% 9.5% 11.2% 6 Embryos not transferred nor frozen Page 22

23 RESULTS 2002 BY WOMAN S AGE - CRYO CYCLES FIVNAT-CH STATISTICS < 29 years years years > 40 years (Cryo cycles) IVF ICSI IVF ICSI IVF ICSI IVF ICSI Initiated cycles % by technique 22.8% 77.2% 26.6% 73.4% 33.1% 66.9% 47.1% 52.9% Oocyte pick-up (OPU) Transfers % of initiated cycles 91.2% 93.3% 90.6% 93.0% 95.1% 91.6% 92.2% 89.1% Transfers with donor's sperm % of Initiated cycles 0.0% 0.0% 0.5% 0.0% 0.0% 0.0% 0.0% 0.0% Thawed zygotes Thawed embryos Embryos transferred Biochemical pregnancies Clinical pregnancies % of Initiated cycles 22.8% 21.2% 15.3% 15.8% 18.9% 15.7% 9.6% 11.6%...% of Transfer cycles 25.0% 22.8% 16.9% 17.0% 19.8% 17.1% 10.4% 13.0% Implantation rate (%) 14.6% 13.9% 10.2% 10.8% 10.6% 9.9% 5.9% 8.2% Page 23

24 RESULTS 2002 BY NO. OF TRANSFERRED EMBRYOS FRESH CYCLES FIVNAT-CH STATISTICS (Fresh cycles) IVF ICSI IVF ICSI IVF ICSI Cycles initiated % by technique 31.3% 68.7% 30.9% 69.1% 24.9% 75.1% Oocyte pick-up (OPU) % of initiated cycles 100.0% 100.0% 99.8% 100.0% 100.0% 100.0% Age woman... Mean Median Q Q Transfers Transfers with donor's sperm % of Initiated cycles 8.1% 0.0% 5.6% 0.7% 2.4% 0.0% Oocytes collected Oocytes inseminated/injected Zygotes 2PN obtained (1) % of inseminated oocytes 46.5% 51.6% 63.5% 65.9% 63.9% 68.5% Cleaved embryos Frozen zygotes (2) Frozen embryos (3) Embryos/Oocytes transferred (4) Embryos not used=1-(2+3+4) % of Zygotes 2PN 6.5% 11.2% 4.0% 4.6% 1.6% 3.3% Biochemical pregnancies Clinical pregnancies % of Transfer cycles 12.1% 11.6% 31.8% 29.2% 34.7% 31.0% Implantation rate (%) 12.1% 11.6% 19.3% 17.2% 15.4% 12.8% 7 Embryos not transferred nor frozen Page 24

25 RESULTS 2002 BY NO. OF TRANSFERRED EMBRYOS - CRYO CYCLES FIVNAT-CH STATISTICS (Cryo cycles) IVF ICSI IVF ICSI IVF ICSI Initiated cycles % by technique 28.7% 71.3% 31.0% 69.0% 37.4% 62.6% Age woman... Mean Median Q Q Oocyte pick-up (OPU) Transfers Transfers with donor's sperm % of Initiated cycles 0.0% 0.0% 0.3% 0.0% 0.0% 0.0% Thawed zygotes Thawed embryos Embryos transferred Biochemical pregnancies Clinical pregnancies % of Transfer cycles 13.7% 8.3% 16.8% 19.1% 26.3% 26.5% Implantation rate (%) 14.5% 8.3% 9.2% 10.8% 9.4% 10.0% Page 25

26 RESULTS 2002 BY DAY OF TRANSFER AFTER FRESH CYCLES FIVNAT-CH STATISTICS IVF ICSI (Fresh cycles) 2 days 3 days 4+ days 2 days 3 days 4+ days Cycles initiated % by technique 28.8% 33.1% 25.5% 71.2% 66.9% 74.5% Oocyte pick-up (OPU) % of initiated cycles 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% Age woman... Mean Median Q Q Transfers Transfers with donor's sperm % of Initiated cycles 5.2% 4.8% 7.4% 5% 0% 0% Oocytes collected Oocytes inseminated/injected Zygotes 2PN obtained (1) % of inseminated oocytes 63.8% 59.9% 55.6% 65.7% 65.1% 70.5% Cleaved embryos Frozen zygotes (2) Frozen embryos (3) Embryos/Oocytes transferred (4) Embryos not used=1-(2+3+4) % of Zygotes 2PN 1.8% 6.8% 14.5% 2.8% 8.4% 10.2% Biochemical pregnancies Clinical pregnancies % of Transfer cycles 29.7% 29.0% 33.3% 27.7% 26.6% 32.9% Implantation rate (%) 18.2% 16.2% 12.5% 15.5% 14.3% 12.3% Singleton 74.4% 79.7% 85.7% 79.7% 76.9% 80.0% Multiple pregnancy 25.6% 20.3% 14.3% 20.6% 23.1% 20.0% 8 Embryos not transferred nor frozen Page 26

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