Assisted reproductive technology in Europe, 1999. Results generated from European registers by ESHRE

The European IVF-monitoring programme (EIM)*, for the European Society of Human Reproduction and Embryology (ESHRE)1, Prepared by K.G. Nygren and A.Nyboe Andersen


    Abstract
 Top
 Abstract
 Introduction
 Materials and methods
 Results
 Discussion
 Appendix I.
 References
 
European results of assisted reproductive techniques from treatments initiated during 1999, are presented in this third report. Data were collected mainly from pre-existing national registers. From 22 countries 538 clinics reported 258 460 cycles: IVF 125 370, ICSI 95 221, frozen embryo replacement (FER) 34 002 and oocyte donations (OD) 3867. In eight countries, where all clinics reported to the register, a total of 99 629 cycles was performed in a population of nearly 106 million, corresponding to 943 cycles per million inhabitants and 3.9 cycles per 1000 women aged 15–49 years. After IVF and ICSI the distribution of transfer of 1, 2, 3 and >=4 or more embryos was 11.9, 39.2, 39.6 and 9.3% respectively. Huge differences existed between countries. For IVF the clinical pregnancy rate per aspiration and per transfer was 24.2 and 27.7% respectively. For ICSI the corresponding rates were 26.1 and 27.9%. These figures represent relative increases by 2.2 to 5.2% compared with 1998. The distribution of singleton, twin, triplet and quadruplet deliveries for IVF and ICSI combined was 73.7, 24.0, 2.2 and 0.1%. This gives a total multiple delivery rate of 26.3%. Triplet deliveries after IVF and ICSI ranged from 0.3–7.0% between countries. Compared with 1998, the number of reported cycles increased by 11% and the clinical pregnancy rate per transfer increased from 27.0 to 27.7% after IVF and from 26.8 to 27.9% after ICSI. Multiple deliveries after IVF and ICSI remained unchanged at 26.3% in 1999.

Key words: ESHRE/Europe/ICSI/IVF/register data


    Introduction
 Top
 Abstract
 Introduction
 Materials and methods
 Results
 Discussion
 Appendix I.
 References
 
This report is the third annual ESHRE publication on European data on assisted reproduction technology (ART). The two previous reports, also published in Human Reproduction (ESHRE, 2001aGo, ESHRE, 2001bGo), covered treatment cycles during 1997 and 1998.

Data has been collected from 22 European countries and covers IVF, ICSI, frozen embryo replacements (FER) and oocyte donations (OD) initiated during 1999. Data from each participating country is sent to ESHRE yearly. A draft report is made and scrutinized by all consortium members, listed in the Appendix at the end of this paper.

A second Consortium meeting was held at the ESHRE meeting in Vienna in July 2002 with representatives from participating countries, where the present and future reporting system was discussed. Here it was noted that Germany reported a marked increased in the coverage in their register. Belgium, Hungary and Switzerland were planning to advance their registration systems from voluntary, non-governmental registers to mandatory registers run by the authorities. Additionally, it was noted that this year Ireland, Poland, Slovenia and Ukraine have joined the European IVF monitoring programme (EIM). Austria will be able to provide data for the year 2000.

The consortium noted that the quality of data still differs between countries. Data collection systems, coverage, definitions and validation are different. Definitions, as suggested by The International Committee on the Monitoring of ART (ICMART) will soon be published in a World Health Organization (WHO) IVF report. These definitions will be considered for adoption by the consortium.

The Consortium again noted that the data quality needs to be improved in the future. European countries still have different data collection systems with a variable degree of coverage, loss of follow-up and different definitions. The Consortium decided to continue to present annual reports and to try to improve the quality of the reports.


    Materials and methods
 Top
 Abstract
 Introduction
 Materials and methods
 Results
 Discussion
 Appendix I.
 References
 
National registers
A total of 16 countries had pre-existing data collection programmes for 1999, and therefore provided data directly from these sources. In Greece, Ireland, Italy, Poland, Slovenia and Ukraine where no such register existed, national data was collected de novo for the purpose of the EIM programme. Details regarding the registers have been described earlier (ESHRE, 2001aGo).

Data collection
The present report summarizes data from ART treatments started during 1999. The data include treatments from IVF, ICSI, OD and FER performed from January 1, 1999 to December 31, 1999. Follow-up data on pregnancies and deliveries are cohort data.

The data collection programmes vary considerably from one country to another. Registers from a number of countries have been unable to provide some of the data. Lack of such specific variables will appear in the tables as ‘not available’ (NA).

The reporting principle used for the 1999 data is basically similar to the preceding year (ESHRE, 2001aGo,bGo). The following eight countries reported data from all clinics in the country: Denmark, Finland, France, Iceland, The Netherlands, Norway, Sweden and Switzerland. In 1998 the UK also reported data from all clinics. In 1999 technical problems within the Human Fertilisation and Embryology Authority (HFEA) had the consequence that only data from a proportion of the clinics were incorporated, and some data were not available.

For 1999, the report includes summary data on complications such as ovarian hyperstimulation syndrome (OHSS), infection and bleeding. Furthermore, data on preimplantation genetic diagnosis (PGD) are also available.

In most countries reports of pregnancies are based on the presence of one or more intrauterine gestational sacs at sonography ~5 weeks after embryo transfer. In some countries such as Denmark and The Netherlands, only pregnancies with a living fetus are recorded. Deliveries were normally reported within the same reporting system as for treatments and pregnancies. For the present report neither the definitions of pregnancies or births have been standardized.

As the data presented here is incomplete and generated through different methods using different definitions in different countries, interpretation of the data must be done with some caution.


    Results
 Top
 Abstract
 Introduction
 Materials and methods
 Results
 Discussion
 Appendix I.
 References
 
Number of treatment cycles
Table IGo shows the number of all treatment cycles recorded in each country, the number of clinics in the country (if available) and the number and size of clinics reporting to the register. The cycles are subdivided into IVF, ICSI, FER and OD. In Belgium, Iceland and Slovenia the number of aspirations were used, as the number of initiated cycles were not available. In total 538 clinics from 22 countries reported 258 460 cycles.


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Table I. ART in European countries in 1999. Number of clinics in the country, number of clinics reporting to the national register and number of initiateda cycles of IVF, ICSI, frozen embryo replacements (FER) and oocyte donations (OD) in 1999
 
Table IIGo shows data from those eight countries where all clinics reported to the register: Denmark, Finland, France, Iceland, The Netherlands, Norway, Sweden and Switzerland. The number of cycles are related to the total population in the country and to the female populations aged 15–49 years. In addition, the number of infants born after ART is expressed as a percentage of the total number of live-born in the country. Overall 99 629 cycles were undertaken in a population of 105.7 million, giving a mean of 943 cycles per million and 3.9 cycles per 1000 women aged 15–49. The percentage of infants born after ART was 1.6% on average and ranged from 0.7–3.6%. If Switzerland, where there is a large loss of follow-up of pregnancies, is excluded, the percentage of children born after ART was 1.7%, with a range from 1.4–3.6%.


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Table II. Art in 1999 in those European countries where all clinics have reported to a national register. Number of reported cycles, deliveries and infants in relation to the population and the national number of live born. Cycles include IVF, ICSI, FER and OD.
 
Size of the clinics
Table IIIGo shows the size distribution of the 538 reporting clinics. The size of a clinic (or unit) is based on all cycles performed per year.


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Table III. Size of IVF clinics reporting to the register
 
Age distribution
Table IVGo shows the age distribution of the treated women in various countries. In the different countries the age range of women <29 years was 6–45%; 30–34 years 31–44%; 35–39 years 18–44% and >=40 years 4–18%.


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Table IV. Percentage age distribution of women treated with IVF and ICSI
 
Number of embryos transferred
Table VGo shows the number of embryos transferred after IVF and ICSI combined. The total number of single embryo transfers was 15 881 (11.9%), dual embryo transfers 52 113 (39.2%), triple embryo transfers 52 646 (39.6%) and >=4 embryo transfers 12 395 (9.3%). As indicated in the Table, wide differences were seen between countries. The range of triple embryo transfers was 4.5–67.3% and the range of transfer of >=4 embryos was 0.0–59.5%.


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Table V. Number of embryos transferred after IVF and ICSI
 
Pregnancies and deliveries after treatment
Tables VI–IXGoGoGoGo show the number of pregnancies and deliveries in relation to the number of initiated cycles, aspirations and transfers for IVF (Table VIGo), ICSI (Table VIIGo), FER (Table VIIIGo) and OD (Table IXGo).


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Table VI. Pregnancies and deliveries after IVF
 

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Table VII. Pregnancies and deliveries after ICSI
 

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Table VIII. Pregnancies and deliveries after FER
 

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Table IX. Pregnancies and deliveries after oocyte donation (OD)
 
Table VIGo shows that after IVF the 27 196 pregnancies resulted from 98 313 embryo transfers. Thus, the mean clinical pregnancy rate per embryo transfer was 27.7%, with a range from 22.7–42.3%. The delivery rates per embryo transfer after IVF have not been summarized due to incomplete follow-up of pregnancies in many countries, as shown in Table VIGo.

Table VIIGo shows that after ICSI the 21 916 pregnancies resulted from 78 452 embryo transfers. Thus the mean clinical pregnancy rate per embryo transfer was 27.9%, with a range from 18.5–35.2%. The delivery rates per embryo transfer after ICSI have not been summarized due to incomplete follow-up of pregnancies in many countries, as shown in Table VIIGo.

Table VIIIGo shows that after FER, 4950 pregnancies resulted from 31 482 transfers. Thus the mean clinical pregnancy rate per embryo transfer after FER was 15.7%. The delivery rates per embryo transfer after FER have not been summarized due to incomplete follow-up of pregnancies in many countries.

Table IXGo shows that after OD 1077 clinical pregnancies resulted from 2802 transfers, giving a pregnancy rate per transfer of 40.0%.

Singleton, twin, triplet and quadruplet deliveries
Table XGo shows the deliveries after IVF and ICSI in relation to singleton, twin, triplet and quadruplet deliveries. It can be seen that the distribution of the deliveries was: singleton 73.7%, twin 24.0%, triplet 2.2% and quadruplet 0.1%.


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Table X. Singleton, twin, triplet and quadruplet deliveries after IVF and ICSI
 
Table XIGo shows the deliveries after FER in relation to singleton, twin, triplet and quadruplet deliveries. It is seen that the distribution of the deliveries was: singleton 84.8%, twin 14.0%, triplet 0.8% and quadruplet 0.4%.


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Table XI. Singleton, twin, triplet and quadruplet deliveries after FER
 
Table XIIGo shows the proportion of infants born as singletons, twins, triplets and quadruplets after IVF and ICSI treatment.


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Table XII. Percentage of infants born as singletons, twins, triplets and quadruplets after IVF and ICSI
 
Pregnancies per embryo
Table XIIIGo presents calculations on the number of clinical pregnancies per embryo replaced after IVF and ICSI. The same parameter can also be expressed as the number of embryos replaced in order to achieve one clinical pregnancy (embryos/pregnancy). It is seen that on average the number of pregnancies per embryo was 0.13 and the number of embryos used to achieve one clinical pregnancy was 7.8.


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Table XIII. Number of pregnancies for each embryo transferred, and the number of pregnancies per transferred embryo (IVF and ICSI)
 
OHSS
Table XIVGo presents the incidence of OHSS recorded from registers in 16 of the 22 countries. It can be seen that 1083 cases of OHSS were recorded after 114 628 cycles, corresponding to 0.9% of all stimulated cycles.


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Table XIV. Complications to IVF. Ovarian hyperstimulation syndrome (OHSS), bleeding and infections resulting in admission to hospital
 
PGD
PGD was recorded in five countries: Denmark, Greece, Hungary, Italy and Portugal. A total of 131 aspirations resulted in 82 transfers, 30 pregnancies and 19 deliveries.

Maternal death
One case of maternal death was recorded.


    Discussion
 Top
 Abstract
 Introduction
 Materials and methods
 Results
 Discussion
 Appendix I.
 References
 
The present report is the third consecutive European report on IVF data covering treatment cycles from 1997, 1998 and 1999 respectively. Europe now has reports on ART, as has been the case for some years in Australia and New Zealand, Latin America and the USA (SART/ASRM, 2002Go).

Four new countries have joined the EIM’s consortium and contribute to the third report and now 22 countries participate, covering the whole of Western Europe with the exception of Austria (who plan to join next year) and Luxembourg where no IVF clinics exist.

Eight of the participating countries already have complete coverage in their reporting systems: Denmark, Finland, France, Iceland, The Netherlands, Norway, Sweden and Switzerland. Germany has improved its coverage, which is now estimated to include around 90% of the activities in that country. Belgium, Hungary and Switzerland have announced the plan to advance their systems into mandatory registers.

The number of reported cycles continues to grow. This year 538 clinics reported 258 460 cycles, which is an increase of 11% compared with 1998. From 1997 to 1998 the increase was 14%. Altogether this means an increase of 25% from 1997 to 1999. This marked increase over 2 years is partly due to a better coverage in the reporting systems but may also be due to a true expansion of activities in some countries. The latest World Report on IVF data (Adamson et al., 2002Go) from 1998, recorded 388 000 procedures world-wide, estimated to represent some 80% of all activities. This means that about 60% of recorded IVF activities globally come from Europe.

Within Europe the largest contributions come from Germany with 60 000 cycles followed by France with 52 000 cycles and the UK with 30 000 reported cycles. It should be noted that the figure from the UK is lower compared with previous years due to technical problems in their reporting system.

The proportion of standard IVF procedures to ICSI procedures remains the same this year compared with last year (56.6% standard IVF and 43.4% ICSI), but in some countries such as Belgium, Greece, Italy, Poland, Portugal, Spain and Switzerland ICSI is more prevalent than IVF. The number of FER cycles remained constant whereas the number of OD cycles showed a small decrease.

The availability of services remained highest in Denmark with 1659 cycles per million inhabitants. It was also high in the other Nordic countries, in The Netherlands and in France. The average number of treatment cycles per million inhabitants in those countries with complete coverage in their reporting was a little below 1000. The proportion of IVF children to all children born was again highest in the Nordic countries with Iceland at 3.6%, Denmark 3.2%, Finland 2.7% and Sweden 2.6%.

The number of embryos transferred in IVF and ICSI cycles differed substantially between countries. The mean number of single embryo transfers remained at about 12%, whereas the proportion of dual embryo transfers increased to 39.2% (compared with 37.2% and 35.7% for 1998 and 1997 respectively). The proportion of three embryo transfers was 39.6%, representing a small decrease from the previous year where it was 42.0%. Four embryo transfers or more remained constant at 9.3%. Finland, Sweden and Slovenia reported no embryo transfers of >=4, and also a low proportion of three embryo transfers, whereas some other countries still reported very high proportions of >=4 embryos transferred.

Pregnancy rates continued to increase slightly. For standard IVF the mean pregnancy rate per transfer was 27.7% (compared with 27.0% for 1998), for ICSI 27.9% (versus 26.8%), for FER cycles 15.7% (versus 14.9%) and for OD cycles 40.0% (versus 30.6% for 1998). Again there were quite large differences between different countries. As an example the pregnancy rate per transfer for IVF cycles varied between 22.7–42.3%.

Delivery rates showed similar trends but one problem remains: in some countries the lost to follow-up rate for deliveries is quite high. Therefore, delivery rates are less valid when compared with pregnancy rates.

One other possibility for reporting success rates would be to report on singleton delivery rates separately. The consortium plans to do so, as soon as the delivery rates are more valid. If only singleton pregnancies are accepted as a success, only ~20% of transfers resulted in a successful outcome.

The occurrence of multiple deliveries did not change from 1998 (26.3%) to 1999 (26.3%). Neither did the twin or the triplet rate change from 1998 to 1999. The triplet rate remained at 2.2% of all deliveries, so the reduction seen from 1997 to 1998 did not continue.

The proportion of singleton deliveries after IVF and ICSI varied between countries within a range of 60.8–83.3%, twin rates from 10.8–32.5% and triplet rates from 0.3–6.4%.

The practice of fetal reduction is very different in different European countries. In some it is quite often practised whereas in others it is not practised at all. The consortium has not, so far, been able to collect reliable data on fetal reductions but is planning to do so in future reports. The proportion of infants (rather than deliveries) for singletons varied from 42–79%, for twins between 19–44% and for triplets between 0.6–15%. The proportion of quadruplets was very low.

Alternative ways of presenting success rates for the whole of Europe showed a pregnancy rate of 0.13 per embryo replaced and that 7.8 embryos needed to be replaced to obtain one pregnancy. These calculations include both singleton and multiple pregnancies.

In this report, for the first time, data on OHSS was collected. Data was not available from all countries. From those reporting, the overall proportion of OHSS was close to 1% with a high of 2.7% and a low of 0.3%. Of course various definitions and also various clinical policies make comparisons difficult.

Altogether 131 aspirations were followed by PGD, and of these 19 babies were delivered. It is expected that these activities will expand in the future. Certainly, a proportion of countries perform PGD, that are not reported within the EIM.

To summarize, this third ESHRE report on IVF cycles carried out in 1999 in Europe shows a continuing expansion of the register, both for participating countries, participating clinics and number of cycles reported. Trends are now becoming visible and there is a trend towards better efficacy. The combined multiple pregnancy rate was reduced from 1997 to 1998, but no further reduction was recorded from 1998 to 1999. With new knowledge on the safety of these procedures it becomes increasingly obvious that the proportion of multiple pregnancies is still much too high, although, at present, quite different in different European countries.


    Appendix I.
 Top
 Abstract
 Introduction
 Materials and methods
 Results
 Discussion
 Appendix I.
 References
 
Contact persons representing data collection programmes in participating European countries, 1999

Belgium: Josiane Van Der Elst, Infertility Centre, University Hospital Gent, De Pintelaan 185, B – 9000 Gent, Belgium. E-mail: josiane.vanderelst{at}rug.ac.be

Czech Republic: Pavel Ventruba, 1st Dept. of Obstetrics and Gynaecology, Masarik University of Brno, Obilni trh 11, 656 77 Brno, Czech Republic. E-mail: ventruba{at}fp-brno.cz

Denmark: Karin Erb, The Fertility Clinic, Odense University Hospital, DK – 5000 Odense, Denmark. E-mail: karin. erb{at}ouh.fyns-amt.dk

Finland: Mika Gissler, Stakes, Stakes information. P.O.Box 220, 00531 Helsinki, Finland. E-mail: mika.gissler{at}stakes.fi

France: Jacques De Mouzon, Inserm U. 292, Hôpital de Bicêtre, 78 rue du Général Leclerc, F – 75252, Kremlin Bicêtre, FRANCE. E-mail: demouzon{at}vjf.inserm.fr

Germany: Ricardo Felberbaum, Med. Univ. Ratzenburger Allee 160, D – 23538 Lübeck, Germany. E-mail: rfelberbau{at}aol.com

Greece: Basil C.Tarlatzis, Infertility & IVF Centre, Geniki Kliniki, 2 Gravias Street,GR – 54645 Thessaloniki, Greece. E-mail: tarlatzis{at}hol.gr

Hungary: Janos Urbancsek, 1st Dept. of Obstetrics and Gynaecology, SOTE, Baross utca 27, H – 1088 Budapest, Hungary. E-mail: Urban{at}Noi1.sote.hu

Iceland: Hilmar Bjorgvinsson. IVF Unit, Depart. Obstet Gynecol, Natiaonal University Hospital. Landspitalinn, Reykjavik 101, Iceland. E-mail: Hilmar{at}rsp.is

Ireland: Edgar Mocanu. HARI Unit, Rotunda Hospital, Dublin1, Ireland. E-mail: emocanu{at}rcsi.ie

Italy: Anna Pia Ferraretti, S.I.S.M.E.R. s.r.l., Via Mazzini 12, I – 40137 Bologna, Italy. E-mail: sismer{at}sismer.it

The Netherlands: Jan A.M. Kremer, Department of Obstetrics and Gynaecology, University Medical Centre St. Radboud, Nijmegen., Geert Grooteplein 10, P.O. Box 9101, NL – 6500 HB Nijmegen, The Netherlands. E-mail: j.kremer{at}obgyn.umcn.nl

Norway: Johan T Hazehamp, Dept. of Reproductive Medicine, Volvat Medical Center, Postboks 5280, Majorstuea, Oslo 303, Norway. E-mail: Hazekamp{at}online.no

Poland: Waldermar Kuczynski, SP Szpital, Dept. Gynecology, MC Sklodowskiej 24 a, 15–276 Bialystok, Poland. E-mail: kuczynsk{at}cksr.ac.bialystok.pl

Portugal: Carlos Calhaz-Jorge. Human Reproduction Unit, Dept. Obstet Gynecol, Hopital de Santa Maria, Av. Prof. Equs Monitz, 1649–028 Lisboa, Portugal. E-mail: Calhazjorge{at}mail.telepac.pt

Russia: V.S.Korsak, IVF Centre, Ott Institute, Mendeleyevskay linia 3, 199034 St-Petersburg, Russia C.I.S. E-mail: ivf{at}mail.ott.ru

Slovenia: Irma-Virant Klun and Toma Tomaevic, University Medical Centre Ljubljana, Department fo Obstetrics and Gynecology, Ljubljana, Slovenia. E-mail: Irma.virant{at}kclj.si

Spain: Jose Luis Ballesca, Unidad de Repoduction, Hospital Clinic, E-08036 Barcelona, Spain.

Sweden: Per-Olof Karlstrom, Reproductive Center, Deopartment of Obstetrics and Gynecology, Academic Hospital, 751 85 Uppsala, Sweden. E-mail: per-olof. karlstrom{at}kk.uas.lul.se

Switzerland: Constanzo Limoni, Via Ceresio 6, 6826 Riva San Vitale, Switzerland. E-mail: alpha5{at}bluewin.ch

UK: Peter Parker, Human Fertilization and Embryology Authority, Paxton House, 30 Artillery Lane, E1 7LS London, UK. E-mail: Peter.Parker{at}hfea.gov.uk

Ukraine: Victor Veselovsky, Clinic Isida IVF, 28/1 Chornovilla Str. Kyiv, 01135, Ukraine. E-mail: vvv{at}isidaivf.com.ua

List of participating countries and centres
Belgium
Aalst: O.L.V. Ziekenhuis – Gynaecologie en Verloskunde

Antwerp: Algemeen Ziekenhuis Middelheim – Dienst Fertiliteit

Bonheiden: Imeldaziekenhuis – I.V.F. Centrum Bonheiden

Brugge: Academisch Ziekenhuis Sint-Jan – BIRTH Fertiliteitskliniek (In cooperation with : Sint-Lucas Ziekenhuis)

Brussels: Akademisch Ziekenhuis – V.U.B. – Centrum voor Reproductieve Geneeskunde; Centre Hospitalier Interrégional Edith Cavell – Centre de Procréation Assistée; Cliniques Universitaires Saint-Luc – UCL – Unité de FIV; Hôpital Erasme U.L.B.- Centre de FIV – Service de Gynécologie; Hôpital Universitaire Saint-Pierre – U.L.B – Clinique de Procréation Médicalement Assistée

Charleroi: Clinique Notre-Dame, Gynécologie et Obstétrique

Edegem: U.I.A – Afdeling voor Infertiliteit

Genk: St.-Jansziekenhuis – Centre for Reproductive Medicine

Gent: A.Z. Jan Palfijn – Centrum voor Fertiliteitstherapie; Gynaecologisch Centrum; Universitair Ziekenhuis Gent – R.U.G. – Infertiliteitscentrum – Vrouwenkliniek

Kortrijk: Sint-Niklaas Kliniek – Fertiliteit, IVF en ET – Dienst Gynaecologie

Leuven: Universitair Ziekenhuis Gasthuisberg – K.U.L – Dienst Gynaecologie; Medical Centre for Fertility – IVF en ET

Libramont: Clinique Notre-Dame, Centre d’Infertilité

Loverval: Institut de Morphologie Pathologique – Laboratoire de F.I.V.

Namur: Centre Hospitalier Régional de Namur

Rocourt (Liège) : Clinique Saint Vincent Centre Liégeois pour l’Etude et le Traitement de la Stérilité

Roeselare: Heilig Hartziekenhuis, Gynecologie

Vilvoorde: Van Helmontziekenhuis – Fertiliteitscentrum SIMAF

Wilrijk: A.Z. St.-Camillus/St.-Augustinus – Infertiliteit

Czech Republic
Brno: CAR 1 – Dept. Ob/Gyn, Masaryk University; CAR 2 – FN Brno; Laurea, Brno; Repromeda s.r.o.; Sanatorium Helios

Ceské Budejovice: Sanatorium ART

Hradec Králové: CAR SANUS

Olomouc: Fertimed; Palacky University, Department of Ob/Gyn

Ostrava: Gyncentrum

Plze: Dept. Ob/Gyn, Charles University Plzen

Praha: CAR – Dept. Ob/Gyn, Charles University; CAR – Dept. Ob/Gyn Charles University FN Motol; GEST Praha; ISCARE IVF; Sanatorium Pronata

Denmark
Aalborg: Fertilitetsklinikken Aalborg

Aarhus: Ciconia Vest; Fertilitetsklinikken Skejby Sygehus; Maigaards Fertilitetsklinik

Brædstup: Fertilitetsklinikken Brædstrup Sygehus

Copenhagen: Ciconia Øst; Dansk Fertilitetsklinik; Fertilitetsklinikken Helsehuset; Fertilitetsklinikken Herlev Sygehus; Fertilitetsklinikken Rigshospitalet; Fertilitetsklinikken Trianglen; Fertilitetsklinikken Hamlet

Horsens: Horsens Fertilitetsklinik

Odense: Fertilitetsklinikken Odense Universitetshospital; Odense IVF-Klinik

Skive: Fertilitetsklinikken Skive Sygehus

Finland
Helsinki: Diacor; Eira Hospital; Family Federation of Finland Helsinki; Felicitas; Helsinki University Central Hospital

Joensuu: Northern Carelia Central Hospital

Jyväskylä: Central Finland Central Hospital

Kuopio: In-Tiimi Kuopio; Kuopio University Central Hospital;

Lappeenranta Fermedi: Fermedi (pls note)

Oulu: Family Federation of Finland Oulu; Oulu University Central Hospital

Tampere: AVA Tampere; Tampere University Central Hospital

Turku: AVA Turku; Family Federation of Finland Turku; Koeputki Oy; Turku University Central Hospital

France
Amiens: Centre Picard; CHU

Angers: CHR

Aubervilliers: La Roseraie

Avignon: Urbain V

Bagnolet: La Dhuys

Bayonne: Lafargue

Besancon: CHU; Les Cigognes

Blanc Mesnil; Clinique

Bois-Guillaume: Saint Antoine

Bondy: Jean Verdier

Bordeaux: Pellegrin Fédération; Pellegrin Gynéco Obstétrique A

Brest: CHU; Pasteur

Bruges: Jean Villar

Caen: CHRU

Cayenne: CHG

Charleville-Mezieres: CH

Clamart: Antoine Béclère

Clermont-Ferrand: CHU

Cormeiller en Parisis: Clinique

Courbevoie: CH-La Défense

Dijon: Chenove; CHR

Epinal: Arc en ciel

Equeudreville: Cotentin

Grenoble: Belledonne; CHU

Guadeloupe-Les Abymes : Les Rosiers

Guilherands Granges: Pasteur

Le Chesnay: Parly II

Le Havre: CH

Le Mans: Tertre Rouge

Le Port: Jeanne d’Arc

Lille: Polyclinique du Bois; Jeanne de Flandres

Limoges: CHRU

Lorient : CH

Lyon Bron: Ste Marie-Thérèse

Lyon: Croix Rousse; Edouard Herriot; Montplaisir; Sainte Anne Lumière

Maisons-Laffitte: Sully

Marseille: Conception; Saint Joseph; Wulfran Puget

Martinique – Fort de France: Sainte Marie

Metz: Sainte Croix

Montpellier: CHU; Saint Roch

Mulhouse: Diaconat

Nancy: A Pinard; Majorelle

Nantes: CHU; N.D. de Grâce; St Herblain / Atlantique

Neuilly: Chérest; Hôpital Américain

Nice: CHU; Saint Georges

Nimes: CHRU

Paris: Bichat; Cochin; Diaconesses; Les Bluets; La Muette; Montsouri; Pitié Salpétrière; Saint Vincent de Paul; Spontini; Tenon

Pau: Lagrange

Perigueux: Francheville

Perpignan: Saint Pierre

Poissy: CHI

Poitiers: CHU

Reims: CHU; Courlancy

Rennes: CHRU Sud; La Sagess

Roanne: CH

Rouen: CHU

Saint Etienne: Michelet

Saint-Jean: L’Union et le Vaurais

Saint-Saulve: Le Parc

Schiltigheim: CMCO

Sevres: J. Rostand

Toulon: Saint Michel

Toulouse: CHU; Saint Jean Languedoc

Tours: CHU; Parc Clinique

Vitry sur Seine: Les Noriets

Germany
Aachen: Universitätsklinikum der RWTH Aachen, Frauenklinik für Gynäkologische Endokrinologie und Reproduktionsmedizin; Prof. Dr O. Bauer

Aalen: Dr R. Rau

Augsburg: Gemeinschaftspraxis Dr Warnecke, Dr Hiller, Dr Bauer, Dr Kraus

Bad Münder: Zentrum für IVF und Reproduktionsmedizin, Deutsche Klinik Bad Münder

Bayreuth: Klinikum Bayreuth

Bedburg/Erft: Praxis Dieter Struller

Berlin: Frauenklinik Charité, Abteilung für Endokrinologie und Reproduktionsmedizin; Praxisklinik für Fertilität, Gemeinschaftspraxis Dr D.J.Peet, Dr P.Sydow; Gemeinschaftspraxis Dr med. Detlef H.G.Temme, Dr med. Rolf Metzger; Gemeinschaftspraxis Dr M.Bloechle, Dr S.Marr, Dr G.Wilke; Charité, Med. Fakultät der Humboldt-Universität zu Berlin, Campus Virchow-Klinikum, Klinik für Frauenheilkunde und Geburtshilfe Reproduktionsmedizin; Fertility Center Berlin

Bielefeld: Frauenklinik Städtische Krankenanstalten

Bonn: Rheinische Friedrich-Wilhelms-Universität, Abteilung für

Klinische Endokrinologie und Reproduktionsmedizin

Bremen: Zentrum für Kinderwunschbehandlung; Evangelische Diakonissenanstalt, Klinik für Frauenheilkunde

Darmstadt: Frauenklinik Klinikum Darmstadt

Deggendorf: Institut für Reproduktionsmedizin

Dortmund: Gemeinschaftspraxis Dres. Med. S.Dieterle and A.Neuer

Dresden: Frauenarztpraxis Dr H.J.Held; Universitätsklinik Carl-Gustav-Carus, IVF Abteilung

Düsseldorf: Gemeinschaftspraxis Dr H.C.Verhoeven, Dr med. M.C.W.Scholtes, Dipl.-med. K.Marx, Dr med. M.Schulte; Frauenklinik der Heinrich-Heine-Universität; Krankenhaus Benrath

Erlangen: Gemeinschaftspraxis Prof. Dr Bregulla, Dr Hamori, Dr Behrens; Dr J.van Uem; Universitätsfrauenklinik

Essen: Gemeinschaftspraxis Dr Th. Katzorke, Dr D.Propping, Dr E.Willms; Universitätsklinikum

Esslingen: Partnerschaftsgesellschaft Dr P.Hermann, Dr J.E.Costea, und Partner; Städtische Frauenklinik

Frankfurt a. M.: Krankenhaus Nordwest

Freiburg: Gemeinschaftspraxis Dr Weitzell, Dr Thiemann, Prof. Dr F.Geisthövel; IVF-Ambulanz der Universitäts-Frauenklinik Freiburg

Gelsenkirchen: Wissenschaftsark Gelsenkirchen, Schwerpunkt Kinderwunschtherapie

Gießen: Gesellschaft zur Förderung der In-Vitro-Fertilisation und Reproduktionsmedizin GbR; Arbeitsgruppe Endokrino- logie, Fortpflanzungsmed. und Mikrochirurgie der Justus-Liebig-Universität

Göttingen: Frauenklinik Georg-August-Universität; Kinderwunschzentrum

Grevenbroich: Gemeinschaftspraxis Dr Kaiser, Dr Tigges, Dr Tuchel

Halle/Saale: Klinikum Kröllwitz, Klinik und Poliklinik für Geburtshilfe und Reproduktionsmedizin

Hamburg: Fertility Center Hamburg, Gemeinschaftspraxis Fischer, Naether, Rudolf; Universitätskrankenhaus Eppendorf, Klinik für Frauenheilkunde; Gemeinschaftspraxis Prof. Dr H.G.Bohnet, PD Dr U.A.Knuth; Gemeinschaftspraxis Dres. Leidenberger, Weise, Hinrichsen,

Graf and Partner GbR; Gemeinschaftspraxis Dr G.Bispink, Dr A.Horn, Dr Michel, Dr Seeler

Hannover: Frauenklinik der MHH am Oststadtkrankenhaus; Gynäkologische Gemeinschaftspraxis Dr K.Bühler, Dr Müseler-Albers, Dr H.P.Arendt

Heidelberg: Ruprecht-Karls-Universität, Gyn. Endokrinologie und Fertilitätsstörungen; Arbeitsgruppe Fortpflanzungsmedizin

Hildesheim: Gemeinschaftspraxis Dr F.-J.Algermissen, Dr P.F.Justus, Dr G.Wilke

Homburg: Universitätskliniken des Saarlandes, Frauenklinik und Poliklinik

Jena: Gemeinschaftspraxis PD Dr H.Fritzsche, Prof. Dr E.Günther

Karlsruhe: Karlsruher IVF-Programm, AG für Fortpflanzungsmedizin, Praxis Dr V.Wetzel

Kiel: Klinik für Gynäkologie der Christian-Albrechts-Universität zu Kiel

Köln: PAN Klinik am Neumarkt; Klinik für Frauenheilkunde und Geburtshilfe der Universitätsklinik zu Köln

Leipzig: Gemeinschaftspraxis Dres. F.A.Hmeidan, P.Jogschies, A.Gabert; Universitätsfrauenklinik Leipzig, Abteilung Reproduktionsmedizin

Lübeck: Universitätsklinikum Lübeck, Klinik für Frauenheilkunde und Geburtshilfe

Magdeburg: Klinik für Reproduktionsmedizin und Gyn. Endokrinologie

Mannheim: Universitätsfrauenklinik GmbH, Klinikum Mannheim

Marburg: Zentrum für Frauenheilkunde und Geburtshilfe Klinikum der Philipps-Universität

Minden: Dr O.P.Happel, Dr O.Buurman, Fachärzte für Frauenheilkunde

Mönchengladbach: Gemeinschaftspraxis Dr D.Döhmen, Dr Thomas Schalk

Mülheim: Evangelisches Krankenhaus, Klinik für Frauenheilkunde

München: Gemeinschaftspraxis Dr W.Bollmann, Dr Th.Brückner, Dr U.Noss, Dr M.Roemisch, Prof. Dr W.Albrich; Gemeinschaftspraxis Prof. Dr med. H.-K.Rjosk, PD Dr, med. A.Römmler, Dr med. H.Lacher, Frauenärzte; Frauenklinik Dr Krüsmann, IVF-Zentrum; Klinikum der Universität München-Großhadern, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe

Münster: Dr L.D.Belkien; Klinik und Poliklinik für Geburtshilfe und Frauenheilkunde und des Instituts f. Reproduktionsmedizin des Zentrums für Frauenheilkunde Westf. Wilhelms-Universität, Bereich für Assistierte Reproduktionsmedizin

Mutlangen: Stauferklinik Schwäbisch-Gmünd

Neubrandenburg: Klinikum Neubrandenburg, Klinik für Frauenheilkunde und Geburtshilfe

Neuwied: Dr J.Beran

Oldenburg: Tagesklinik Dr E.Dewitt; Dr J.Hennefründ, Dr Ochs-Ring; Dr med. Saif Jibril

Osnabrück: Gemeinschaftspraxis Dr W. von der Burg, Dr I.Coordes

Pforzheim: Zentrum f. Reproduktionsmedizin in d. Zentralklinik

Prien: Gemeinschaftspraxis Dr M.Lehnert, PD Dr R.Steldinger

Regensburg: Gemeinschaftspraxis Dr med. A.F.Liebl, Prof. Dr med. B.Seifert

Remscheid: Gynäkologische Endokrinologie und Reproduktionsmedizin am Klinikum Dr Johannes Luckhaus

Rostock: Frauenklinik Rostock, Med. Fakultät der Universität

Saarbrücken: Gemeinschaftspraxis Dr J.Happel, Dr L.Happel, Dr M.Thaele

Schwerin: Medizinisches Zentrum der Landeshauptstadt Schwerin, Klinikum Schwerin

Stralsund: Klinikum der Hansestadt Stralsund GmbH, Klinik für Gynäkologie und Geburtshilfe

Stuttgart: Dr med. Mayer-Eichberger

Tübingen: Frauenklinik Eberhard-Karls-Universität

Ulm: Universitätsklinikum; Zentrum für Sterilitätsbetreuung

Wiesbaden: Zentrum für Reproduktionsmedizin

Würzburg: Gemeinschaftspraxis Dr R.Mai, Dr W.Schmitt; Universitätsfrauenklinik

Greece
No list

Hungary
Budapest: ‘Jahn Ferenc’ Hospital, Department of OB/GYN; ‘Nyiro Gyula’ Hospital, Department of OB/GYN; Semmelweis University of Medicine, 1st Department of OB/GYN; St. John’s Hospital, Department of OB/GYN

Debrecen: Medical University of Debrecen, Department of OB/GYN

Pécs: Medical University of Pécs, Department of OB/GYN

Iceland
Reykjavik: IVF-Unit, National University Hospital

Ireland
Dublin: Hari, Rotunda Hospital – JMS

Galway: IVF Unit, UCH Galway

Italy
Abano Terme (Pd): Casa di Cura Abano Terme –Centro Ripr. Assistita

Bari: Clinica S. Maria; Studio Medico ‘San Luca‘; Studio Associato CECOS

Bologna: S.I.S.ME.R.; Tecnobios; Centro Sterilità e Fecondazione Assistita Università di Bologna

Bolzano: Ospedale di Bolzano

Brescia: Istituto Clinico ‘Città di Brescia’

Bressanone (Bz): Ospedale di Bressanone

Brunico (Bz): Ospedale di Brunico

Cagliari: Ospedale Regionale Microcitemie; Università di Cagliari

Cassano Murge (Ba): Casa Bianca

Catania: C.R.A.

Cittadella (Pd): Ospedale di Cittadella

Firenze: Centro ‘Demetra‘; Centro ‘Futura’

Fossano (Cn): Ospedale di Fossano

Genova: Biotech; Università di Genova

Gragnano (Na): A.O.G.O.I.

Lecce: Centro di Fecondazione Assistita; Centro Studi Riproduzione Umana

Manduria (Ta): Ospedale M. Giannuzzi

Mantova: Ospedale C. Poma

Mercogliano (Av): Diagnostica Medica

Messina: Centro di Riproduzione Umana

Mestre (Ve): ARC-STER

Milano: Fondazione S. Raffaele del Monte Tabor; Polo Universitario S. Paolo

Modena: Università di Modena e Reggio Emilia

Monza (Mi): Centro ‘Biogenesi’

Motta di Livenza (Tv): Ospedale di Motta di Livenza

Napoli: Centro Mediterraneo di Fecondazione Assistita

Nardò (Le): Tecnomed – Centro Medico Biologico

Padova: Studio ‘Gemma‘; S.I.S.ME.R. Padova

Palermo: Centro ‘Andros‘; Centro Biologia della Riproduzione

Parma: Università di Parma

Pesaro: Centro Salus

Pescara: Villa Serena

Pisa: Casa di Cura S. Rossore; Università di Pisa

Reggio Emilia: Studio Diagnostico Raul Palmer

Rimini: Ospedale di Rimini

Roma: European Hospital; Genesis

Rozzano (Mi): Istituto Clinico Humanitas

Salerno: C.M.R.; Human Fertilization Center

Sassari: Università di Sassari

Sora (Fr): Centro S.T.S.

Torino: Laparoscopy and Fertility Center; Centro LIVET; Ospedale S. Anna; Centro Diagnosi e Cura dell’Infertilità di Coppia; Fertilab

Trieste: Ospedale Burlo Garofalo

Udine: S.I.S.ME.R. Udine

Varese: Centro Diagnostico Varesino

The Netherlands
Amsterdam: Academisch Medisch Centrum, Vrije Universiteit Medisch Centrum

Eindhoven: Catharina Ziekenhuis

Groningen: Academisch Ziekenhuis Groningen

Leiden: Leids Universitair Medisch Centrum, Stichting Medisch Centrum voor Geboorteregeling

Maastrict: Academisch Ziekenhuis Maastricht

Nijmegen: Universitair Medisch Centrum St Radboud

Rotterdam: Academisch Ziekenhuis Rotterdam

Tilburg: St. Elisabeth Ziekenhuis

Utrecht: Universitair Medisch Centrum

Voorburg: Reiner de Graaf Groep

Zwolle: Isala Klinieken

Norway
Bergen: Haukesund Sykehus, Universitetssykehus i Bergen

Haugesund. Fylkesykehuset i haugesund

Oslo: Rikshospitalet, Universitetssykehus. Ullevål Universitetssykehus, Volvat Medisinske Senter, Omnia Fertilitetssenteret

Tromsø: Universitetssykehuset Nord-Norge

Trondheim: St. Olavs Hospital, Universitetssykehus

Poland
Bialystok: Department of Gynecology, Medical Academy of Bialystok

Bytom: Department of Obstetrics and Gynecology, Silesian Medical University

Warsaw: Private Policlinic ‘Ovum’

Portugal
Guimarães: Hospital N. S. da Oliveira

Lisboa: CLIFER; CLINDIGO; Hospital de Santa Maria; Maternidade Dr Alfredo da Costa

Oporto: Centro de Genética Prof. Alberto Barros; Maternidade Júlio Dinis

Vila Nova de Gaia: Centro Hospitalar

Slovenia
Ljubljana: Medical Center Ljubljana

Maribor: Maribor Hospital

Postojna: Postojna Hospital

Spain
Alicante: Instituto Bernabeu; Unidad de Reproduccion Vistahermosa

Aravaca: Urh. Garcia del Real

Badajoz: Clinica Gonzalez Carrera

Baracaldo (Vizcaya): Hospital de Cruces

Barbera del Vallés: Centro de Reproduccion Humana del Valles Occidental

Barcelona: CIRH, Clinica de Reproduccion Asistida; Hospital Clinico de Barcelona; Hospital de la Santa Creu i Sant Pau; Instituto de Medicina Reproductiva; Instituto Marques; Instituto Universitario Dexeus

Bilbao: Clinica Euskalduna

Cordoba: Centro Mesa Dominguez; Clinica Bau

Godella: Instituto de Medicina Reproductiva

Granda: Centro de Reproduccion Asistida y Genética Reproductiva; Centro de reproduccion Humana; Hospital universitario ‘Virgen de las Nieves’

Llobregat: Hospital de Llobregat, Centre Tocoginecologico

La Flota: IVI Murcia

Lleida: CIRH Lleida

Madrid: Centro de Reproduccion Humana; Clinica Tambre; Fundacion Jimenez Diaz; Hospital Maternal ‘La Paz‘; Instituto Ginecologico ‘La Cigüena‘; IVI Madrid; Madrid FIV

Malaga: Centro Gutemberg

Oviedo: CEFIVA

Palma de Mallorca: Centro de Fecundation In Vitro Baleares; Instituto Balear de Infertilidad

Reus: Instituto de Infertilidad y Reproduccion Humana Conceptum

Sabadell: Centre Medic Fuster

San Sabastian: Clinica Quiron Donostria

Sevilla: Centro Hispalense de Reproduccion Asistida

Valencia: IVI Valencia

Russia
Cheboksary: Republican Center for Family Planning and Reproduction, Ministry of Health Chuvashia Republic. Director A.V.Samoilova

Krasnoyarsk: Center for Reproductive Medicine. Director A.V.Svetlakov

Moscow: IVF Department of Sechenov Medical Academia. Head of Dept. E.A.Kalinina

Medical Center for IVF. Director E.I.Pomeranceva. Center for Family Planning and Reproduction, IVF Department. Head of Dept. A.S.Kalugina Center for Infertility Treatment ‘IVF’. Director V.M.Zdanovsky

Center ‘Lera’. Director V.M.Zdanovsky, Medical Center for Infertility Treatment ‘Embryon’. Director K.N.Kechiayn Rostov-Don: Center of Human Reproducton and IVF. Medical Director A.V.Kuzmin

Samara: Medical Company ‘IDK’. Director V.I.Karnauch

Saratov: Region Center for Family Planning and Reproduction. Director N.P.Smirnova

St.Petersburg: International Center for Reproductive Medicine, Ob/Gyn Ott Institute. Medical Director Proffesor V.S.Korsak, Center for Family Planning, Pushkinsky District. Medical Director A.V.Ivanov Russian Finnish Medical Center ‘AVA-Peter’. Director N.V.Kornilov.

Baltic Institute of Human Reproductology. Director A.I.Nikitin

Tumen: Center for Reproductive Medicine ‘Mercury’. Medical Director E.V.Popenko, Medical Center ‘Malish’. Medical Director N.M.Kovalev

Voroneg: Region Center for Family Planning and Reproduction, IVF Department. Director N.N.Shemarinova

Vladivostok: Medical Center for IVF ‘Santa Maria’. Director V.A.Belikov

Sweden
Falun: IVF-enheten Falu lasarett

Göteborg: Fertilitetscentrum, Carlanderska sjukhemmet; Sahlgrenska universitetssjukhuset

Linköping: Universitetssjukhuset

Malmö: Curakliniken; Oeresundklinikken; Malmö allmänna sjukhus

Stockholm: Huddinge sjukhus; Karolinska sjukhuset; Lucinakliniken; Sophiahemmet

Umeå: Norrlands universitetssjukhus

Uppsala: Akademiska sjukhuset; Carl von Linnékliniken

Örebro: Regionsjukhuset

Switzerland
Baden: Reproduktionsmedizinisches Zentrum Kantonsspital

Basel: IVF-ICSI Zenter Institut Dr Viollier, Dr N. Pavic, Dr J-C. Spira; Universitäts-Frauenklinik, Abt. für gynäkologische Endokrinologie und Reproduktionsmedizin

Bellinzona: ProCrea, Centro Fertilità della Svizzera Italiana

Bern: Lindenhofspital, IVF-Labor; Universitätsfrauenklinik, Abt. für Gynäkologie, IVF und Reproduktionsmedizin, Inselspital

Frauenfeld-Kreuzlingen: IVF Zenter ILAMED

Genève: Centre Privé de Procréation Médicalement assistée de la Clinique de Champel Elysée; Hôpital Universitaire, Clinique et Policlinique de Stérilité et d’Endocrinologie Gynécologique

Laufen: Dr A. Koller

Lausanne: Centre Vanderlick-Montchoisi; CHUV, Unité de Médecine de la Reproduction et d’Endocrinologie Gynécologique

Locarno: Centro Cantonale di Infertilità, Servizio di Endocrinologia Ginecologica

Luzern: Kantonalspital, Sterilitätssprechstunde Frauenklinik, IVF-ICSI Labor

Schaffhausen-Zürich: Zentrum für Reproduktionsmedizin, Dr P Fehr, Dr Singer

Winterthur: Dr R. Köppel

Zollikerberg: IVF Zürich

Zürich: Universitätsspital, Klinik für Endocrinologie

Ukraine
Kharkiv: Center for Reproductive Medicine ‘Implant’

Kyiv: Institute of Reproductive Medicine; Isida IVF Clinic

Odessa: Center for Reproductive Medicine ‘Remedi’

UK
No list.


    Notes
 
1 Address for correspondence: ESHRE Central Office, Van Aakenstraat 41, B-1850 Grimbergen, Belgium. E-mail: info{at}eshre.com Back

* EIM subcommittee: Chairman, K.G.Nygren; co-ordinator, A.Nyboe Andersen; member, L.Gianaroli. See Appendix for contributing centres and contact persons representing the data collection programmes in the participating European countries. Back

Report prepared by K.G.Nygren and A.Nyboe Andersen


    References
 Top
 Abstract
 Introduction
 Materials and methods
 Results
 Discussion
 Appendix I.
 References
 
Adamson, D., Lancaster, P., de Mouzon, J., Nygren, K.-G., Zegers-Hochshield, F. and International Working Group for Registers on Assisted Reproduction (IFFS Task Force) (2002) World collaborative report on assisted reproductive technology, 1998. In D.L. Healy, G.T. Kovacs, R. McLachlan and O.Rodrigues-Armas O (eds). Reproductive medicine in the twenty-first century. Proceedings of the 17th World Congress on Fertility and Sterility, Melbourne Australia. Parthenon, New York, USA. 209–219.

ASRM/SART Registry (2002) Assisted reproductive technology in the United States: 1998 results generated from the American Society for Reproductive Medicine/Society for Assisted Reproductive Technology Registry. Fertil. Steril., 77, 18–31.[ISI][Medline]

ESHRE (2001a) The European IVF-monitoring programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE). Assisted reproductive technology in Europe, 1997. Results generated from European registers by ESHRE. Hum. Reprod., 16, 384–391.[Abstract/Free Full Text]

ESHRE (2001b) The European IVF monitoring programme (EIM), for the European Society of Human Reproduction and Embryology (ESHRE). Assisted reproductive technology in Europe, 1998. Results generated from European Registers by ESHRE. Hum. Reprod., 16, 2459–2471.[Abstract/Free Full Text]