Plateauing IVF Pregnancy Rates in Europe a Stark Contrast to the US Rates, Says a Fertility Expert

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The differing approaches toward infertility treatments between the US and Europe may be responsible for the enormous discrepancy in pregnancy rates.

Center for Human Reproduction

If there is a lesson to be learned here, it is that IVF pregnancy rates in the U.S. will continue to improve, as long as IVF research and clinical care remain largely unaffected by government interference

Recent reports of plateauing IVF pregnancy rates in Europe are in stark contrast to still-rising rates in the US, according to Norbert Gleicher, M.D., a prominent fertility expert and Medical Director of the Center for Human Reproduction (CHR) in New York City. Behind this difference may be a fundamental difference in approaches to the patient-physician relationship in Europe and the US.

Focus on Reproduction, the official magazine of the European Society for Human Reproduction and Embryology (ESHRE), recently reported that in Europe overall IVF pregnancy rates have leveled off.

As first reported by Dr. Gleicher’s team in 2006(1,2), European IVF pregnancy rates are significantly lower than American rates. The most recent European data show clinical pregnancy rate per cycle of 32.5%. Conservatively assuming a miscarriage rate of 15%, this would translate into delivery rates of 26.6%. During the same time period, the US delivery rate was 40.7%.

The question is why.

“A part of the reason is the recent propagation of single-embryo transfer (sET) in Europe,” explains Dr. Gleicher. “In Europe, fertility experts and governments alike consider the reduced risk of multiple pregnancies through sET a good enough reason to offset lower pregnancy chances caused by sET. Thus, many European countries mandate sET despite irrefutable evidence that patients value nothing more than better chances of pregnancy in choosing their infertility treatments.

“This is a good example for the fundamental difference in the socio-medical philosophy between Europe and the US,” points out Dr. Gleicher: “Europe values what they perceive as the ‘common good’ over individual rights of patients. What they fail to recognize, however, are the unintended consequences affecting the patient-physician relationship and, most importantly, IVF outcomes.”

He continues: “Not only do patients end up with much lower pregnancy chances with IVF than their U.S. counterparts, they, in the end, are also forced to undergo more IVF cycles , at more cost, and, of course, more risks.” Europe, therefore, performs more than three-times as many IVF cycles per capita than the US. The same philosophy in Europe also results in outright rationing. For example, most Scandinavian countries withhold all IVF treatment from women above age 40-41, an approach unthinkable in the US.

“If there is a lesson to be learned here,” says Dr. Gleicher, “it is that IVF pregnancy rates in the U.S. will continue to improve, as long as IVF research and clinical care remain largely unaffected by government interference, and primarily driven by success in the marketplace, as they have over the last few decades.”

(1)Gleicher et al. A formal comparison of the practice of assisted reproductive technologies between Europe and the USA. Hum Reprod 2006;21:1945-50; (2)Gleicher et al. Update on the comparison of assisted reproduction outcomes between Europe and the USA: the 2002 data Fertil Steril 2007;87:1301-5.

About Center for Human Reproduction
Center for Human Reproduction, or CHR, is a leading fertility center in the United States with a worldwide reputation as a "fertility center of last resort," specializing in treatment of infertility in women with diminished ovarian reserve. Under the leadership of Dr. Norbert Gleicher, CHR has been helping many European patients—in addition to local New York and North American patients—receive state-of-the-art fertility treatments. Dr. Gleicher is available for additional comments.


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