International Committee for Monitoring Assisted Reproductive Technologies world report: assisted reproductive technology, 2019

OBJECTIVE: To report the utilization, effectiveness, and safety of assisted reproductive technologies (ARTs) in 2019. DESIGN: A retrospective, cross-sectional survey derived from cycle and pregnancy outcome data submitted by national and regional registries. SUBJECTS: Patients undergoing ART procedures. INTERVENTION: Assisted reproductive technology. MAIN OUTCOME MEASURES: Outcomes on country, regional, and global levels. RESULTS: There were 3,544,683 cycles with 783,073 infants born reported. There were an estimated ≥3,855,694 cycles with >865,914 infants in reporting countries including nonreporting clinics. The reported number of cycles and infants increased by approximately 8% from 2018. Autologous frozen-thawed transfers accounted for 61.8% of all autologous transfers without preimplantation genetic testing (PGT), up from 14.8% in 2015. Among all reporting countries, the percentage of freeze-all cycles was 38.4% in 2019, up from 24.6% in 2015. There were 233,833 initiated PGT cycles reported from 44 countries, representing 6.6% of reported cycles vs. 2.6% in 2015. The delivery rate for autologous oocytes was 22.9% per aspiration, with a cumulative delivery rate of 38.6% per aspiration (excluding PGT). Per transfer, the delivery rates were 31.3% for autologous fresh transfers, 31.9% for autologous frozen transfers, 48.7% for transfers using PGT, and 34.6% for transfers after oocyte donation (combined fresh and frozen transfers).In fresh autologous cycles (excluding PGT), the mean number of transferred embryos was 1.51, the proportion of single embryo transfers was 55.6%, and the multiple delivery rate was 17.7%. In autologous frozen-thawed cycles (excluding PGT), the mean number of transferred embryos was 1.26, the proportion of single embryo transfers was 74.1%, and the multiple delivery rate was 13.0%. With oocyte donation (combined fresh and frozen transfers), the multiple delivery rate was 10.8%. The multiple delivery rate for cycles using PGT was 4.2%. CONCLUSION: The International Committee for Monitoring Assisted Reproductive Technologies report is the most comprehensive summary of global ART utilization, effectiveness, and safety currently available. The report documents an increase in reported cycles and infants born from previous years, growing utilization of embryo cryopreservation and single embryo transfers, increasing numbers of PGT cycles, and a reduction in multiple deliveries. It also provides a benchmark for the impact of the coronavirus disease 2019 pandemic in 2020.