World-first count redefines role of IVF

A world-first estimate shows assisted reproductive technology (ART) is now part of everyday life for millions of families across the globe, with one ART-conceived baby born every 35 seconds.

Between 10 and 13 million babies were born via in vitro fertilisation (IVF) in the 40 years since the world’s first IVF infant was born in 1978, according to a new study. Australia now sees one in every 16 babies born via IVF. Among women aged over 35, that figure is closer to one in 10.

“Every year we estimate how many babies were born in the previous 12 months – but we’ve never actually gone back and used a consistent methodology and extrapolation for missing data to estimate the total number of babies born in the world,” said Professor Georgina Chambers, one of the study’s lead authors and director of UNSW’s National Perinatal Epidemiology and Statistics Unit (NPESU).

Australia has played a formative role in IVF’s early history as the third country to successfully deliver an IVF baby in 1983. Since then, the nation has become a global leader in both the safety and success of IVF – with data from Australia and New Zealand being among the most complete in the world.

“Australia was the first country to establish an IVF registry, thanks to the pioneers who collaborated with the NPESU and Fertility Society of Australia and New Zealand (FSANZ) in the early 1980s,” said Prof. Chambers.

The study was based on 1978–2018 data collected on behalf of the International Committee Monitoring Assisted Reproductive Technologies (ICMART), of which Professor Chambers is data custodian.

“IVF is expensive and complex,” stated Professor David Adamson, Chair of ICMART. “It requires skilled personnel, medications and high-tech labs. Without public funding or reimbursement, it’s largely inaccessible in many parts of the world.”

IVF is practiced differently in each country – particularly when it comes to the number of embryos transferred during treatment, as well as the use of frozen embryos.

“Multiple births used to be very common with IVF because clinics would transfer more than one embryo to try and improve the chance of pregnancy,” Professor Adamson said “With improvements in embryo freezing techniques, embryos can now be successfully transferred in subsequent cycles. A single embryo transfer does not compromise overall success rates – and it is safer for mother and baby.”

Australia has been a global leader in reducing multiple birth risk. Professor Chambers explained, “Today, more than 93% of IVF cycles involve a single embryo transfer, resulting in a multiple birth rate of below 3%. Most IVF babies in Australia now come from frozen embryos.”

With declining birth rates across most of the world, to the effect that Europe’s population will start falling from 2026, “many, countries now are turning to IVF and supporting it through government funding to support or reverse the declining fertility rates,” Prof. Chambers said “But it’s not a particularly effective pronatalist policy to fund IVF with that as its sole goal.”

While IVF can help individuals and couples have children, it makes only a small difference to overall fertility rates.

“Fertility treatment is a medical treatment for infertility,” Professor Chambers said. “While this can help increase birth rates among women in their mid-30s and older, it shouldn’t be relied on as a tool to reverse declining population trends.

“Access to fertility care should reflect the fact that it is a universal human right to build a family. Australia has been a global leader in recognising this – providing the financial, societal and medical support to enable its people to access fertility care equitably,” she added.

IVF could potentially have a detrimental effect on fertility rates because of a common misunderstanding that IVF can readily solve infertility if needed – where people may put off having children until an older age, when IVF is less successful. This can lead to the physical, emotional and financial strain of attempting IVF without it being successful, according to Professor Chambers.

“For each fresh or frozen IVF cycle started in 35-year-old women, the live birth rate is around 30%, this drops to 15% for a 40-year-old and 10% for a 42-year-old,” she commented.

Behind each of the millions of IVF births is a deeply personal and emotional journey. Professor Chambers explained that what the data behind the study shows is how transformative assisted reproduction is.

“Over a relatively short period of time IVF has become an important medical and societal procedure in terms of assisting people who are infertile to have children,” she said. “This includes same sex couples and single women – In Australia, these patients account for around 17% of cycles. However, in many parts of the world IVF is not accessible for them.”

“As more babies are born through IVF, we hope access to safe, high-quality care will become more equitable – and based on human rights – across the world,” Professor Chambers added.

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