Spain continues to set pace in European ART

Published 05 December 2019

Total cycles increase by only 2%, with the majority of transfers derived from frozen embryos. Egg donation represents around one-third of all activity and around half of all cross-border treatments.

Spain continues to set the pace in European ART but its latest report - on activity during 2017 - shows only a small increase in cycle numbers over the previous year. In 2016, 138,553 cycles were reported to the national registry run by the Spanish Fertility Society, which increased by 1.7% to 140,941 cycles in 2017. It was in 2015 (with data from 2014) that all Spanish clinics were required by law to refer their data to the Spanish Fertility Society's registry. This meant a huge increase in cycles reported from Spain and the elevation of Spain to Europe's most prolific ART country, where it still remains.

More than one-third of the Spanish cycles of 2017 (37%) were IVF/ICSI with fresh oocytes, with frozen cycles accounting for a further 20% of treatments. The former (fresh transfers) represented a slight decrease on 2016 activity (-5.9%). Egg donation, in a fresh or frozen cycle, accounted as ever in Spain for some 30% of all activity; 7000 of the total egg donation cycles were with vitrified oocytes.

A clinical pregnancy rate of 41% per transfer was recorded from all ART treatments, with a live birth rate of 29.6% per transfer. The 33,640 babies born after treatments in 2017 represented 8% of all babies born in Spain, said Dr Fernando Prados of the Spanish Fertility Society presenting the data in Madrid in October. The multiple delivery rate after fresh embryo transfer was reduced to 15%, with single embryo transfers rising from just over 30% of all non-donor cycles in 2016 to 40% in 2017. The number of double embryo transfers continues to decline. This trend is even more marked in egg donation, where SET has - for the first time in 2017 - overtaken DET as the preferred protocol.

Of great interest to countries outside Spain are cross-border treatments, which according to the latest figures represented around 10% of the Spanish total, a slight decrease on 2016 data. By far the most frequent travelers (48%) were from France, which in 2017 maintained its strict legislation outlawing treatment of lesbian and single women, followed by Italy (23%). Around one half of all Spain's cross-border treatments were for egg donation, as in 2016.

Commenting on the results Dr Prados noted the consistent number of egg donation cycles between 2017 and 2016, where - in contrast to non-donor cycles - there was a trend towards an increased use of fresh embryo transfers. Moreover, he said, while the total number of all cycles seems to have similarly plateaued in Spain, it is evident that 'traditional' treatments are losing ground to newer approaches. The number of PGT-A cycles increased sharply in 2017, and freeze-all treatments continued their steady rise, accounting for 22% of all non-donor cycles.

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