ART includes:

• In vitro fertilization-embryo transfer (IVF-ET). Approximately 99 percent of ART cycles performed are IVF-ET.  
• Gamete intrafallopian transfer (GIFT).
• Zygote intrafallopian transfer (ZIFT).
• Frozen embryo transfer (FET).
• These techniques also apply to oocyte donation and gestational carriers.  
• ART may be recommended when other treatments (such as intrauterine insemination) have not been successful or when there is severe male factor infertility, severe endometriosis or tubal obstruction. 

ART Globally:

• The world’s first test-tube baby was been born in Britain in 1978.
• By 2012, approximately 1.5 million ART cycles were being performed annually worldwide, with an estimated 1,150,000 failed cycles (76.7 percent) compared to 350,000 (23.3 percent) live births.
• Across the globe today, an estimated 9 percent of women aged twenty to forty-four experience infertility lasting more than twelve months, and most who seek out ART are between the ages of thirty and thirty-nine

For more information go to: http://www.eshre.eu/ESHRE/English/Guidelines-Legal/ART-fact-sheet/page.aspx/1061

An Expanding Global Business:

• The global market for infertility drugs and devices will reach nearly $4.8 billion in 2017, according to an October 2012 report from Transparency Market Research.
• The industry is expected to grow at a compound annual growth rate of 4.3 percent from 2012 to 2017.
• Emerging nations such as India, Brazil, China and Mexico are considered to be the most lucrative markets (This prediction is likely linked to an expanding “reproductive tourism” business).

For more information go to: http://www.healthcarefinancenews.com/news/global-infertility-drugs-devices-market-approach-48b-2017

What is infertility?

There is no globally agreed upon definition of “infertility.” The definition remains inconsistent in medical and scientific literature. The word “infertility” is used synonymously with sterility, infecundity, childlessness, and subfertility.

• The World Health Organization has changed its definition of infertility multiple times in the last 30 years:
• 1975: 2 years
• 1985: 12 months
• 2001: 2 years
• 2009: 12 months
• 2012: 2 years (current website - http://www.who.int/topics/infertility/en/)

• In the United Kingdom, a couple is defined as infertile if after two years of unprotected intercourse the woman has not become pregnant.
• In 2004 the National Institutes of Health defined couples as being infertile if after two-years of unprotected sex the woman had not become pregnant.
• Clinicians often define infertility after one year of unprotected sex two to three times a week that does not result in a pregnancy. The timeframe is reduced to six months after the age of 35.
• In 2008, the American Society for Reproductive Medicine changed its definition of infertility to one year of unprotected sex for couples younger than thirty-five and six months for couples older than thirty-five.
• Demographers tracking health patterns in large populations rely on a five-year study window to accurately determine infertile status.

For more information go to:
http://www.pophealthmetrics.com/content/10/1/17
http://humupd.oxfordjournals.org/content/17/5/575.full.pdf
http://www.hfea.gov.uk/infertility-facts.html

How common are Fertility treatments and ART in the United States?

• Data from the Centers for Disease Control (CDC) suggest that 1.2 million women of reproductive age have had infertility-related medical appointments within the previous year, and an additional 10 percent had received infertility services at some time in their lives.
• The U.S. National Survey of Family Growth reports that an estimated 7.3 million people experience infertility, or one out of every eight couples.
• Almost 12 percent of U.S. women aged 15 to 44 have reported using some type of infertility service.
• According to the CDC, in the U.S. one in five women now has her first child after age 35, an eightfold increase compared with a generation ago.
• In August 2008, the U.S. Census reported that the number of women aged forty to forty-four who remain childless had doubled in a generation. In June 2006, 20 percent in that age group remained childless compared to only 10 percent thirty years earlier—prior to the increasing reliance of fertility treatments as a last resort.

2010 ART Data from the Centers from Disease Control:

• The CDC’s 2010 data show that nearly 150,000 ART cycles were reported at 443 clinics—about 91 percent of the total number of clinics in the United States. This resulted in an estimated 47,090 (31.3 percent) live births during that year, with roughly 102,910 (68.6 percent) failed cycles.
• By age group, of the 31.3 percent of cycles that succeeded in 2010:

• 42 percent in women younger than 35 years of age
• 32 percent in women aged 35–37 years
• 22 percent in women aged 38–40 years
• 12 percent in women aged 41–42 years
• 5 percent in women aged 43–44 years

• The CDC reports that in most age groups in America, percentages of ART cycles that result in live births were lower for women who had previously undergone an unsuccessful cycle.
• A 2007 State of Fertility report issued by IntegraMed America Inc.—the nation’s largest chain of clinics—indicates that the percentage of female college graduates between the ages of twenty-two and twenty-nine seeking ART grew by 23 percent from 1995 to 2002. It is not clear how many of these women are egg donors.
• There are an estimated 500,000 frozen embryos in the United States.

What is the average cost of fertility treatments and ART in the United States?

• The average cost of an IVF cycle in the United States it $12,500.
• The average cost of drugs per cycle used by women undergoing IVF is $5,000.
• The average cost of a donor egg cycle is $30,000.
• Only 15 states have laws requiring insurance coverage for infertility treatment and what they cover varies from state to state: Arkansas, California, Connecticut, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas and West Virginia.
• Egg donors are paid anywhere between $5,000 and $100,000 or more depending on private contract negotiations.
• Surrogacy ranges on average between $75,000 and 200,000 or more depending on private contract negotiations.
• The average cost for a woman to freeze her eggs with an unproven technique known as vitrification (flash freezing) is between $10,000 and $22,000.

How common are donor egg cycles?

• A 2007 New York Times article reported that 15,175 donor egg cycles were being performed annually in the United States, with roughly one-third of cycles ­­––5,449—resulting in live births.
• Clinics are not required to report the number of cancelled donor egg cycles.
• The donor egg industry in 2007 was earning $38 million dollars annually and growing by 6 to 8 percent each year.
• There are no laws regulating the fee an egg donor is paid. On average and egg donor is valued at anywhere between $5,000 and $100,000, depending on private contracts between recipients and donors.

What is egg freezing?

In October of 2012 the American Society for Reproductive Technology removed the “experimental” label from a new egg freezing technique known as vitrification, or flash freezing.

• This technology was originally developed for women under the age of 30 suffering from illnesses that required treatments that could potentially damage their reproductive organs.
• To date, 1000 children have been born from this technology.
• No safety studies have been conducted on children born from these technologies.
• No studies have been conducted to assess if flash-freezing eggs is effective in women over the age of 30.
• The average cost of flash-freezing eggs is between $10,000.00 and $22,000.00.

ART and Birth Defects in Children:

In May 2012, the New England Journal of medicine published the world’s most comprehensive study finds for higher birth defect risks among children born from ART. The University of Adelaide's Robinson Institute and School of Paediatrics and Reproductive Health conducted the study.

• Researchers examined records from 302,811 pregnancies, including stillbirths and terminations, between January 1986 and December 2002 that resulted from spontaneous conception, and 6,163 that resulted from fertility treatments.
• Considering all methods together, there was a 28 percent greater risk for birth defects in babies conceived with fertility treatment, including increased risks for heart, muscle, uro-genital and gastrointestinal defects, and for cerebral palsy.
• While assisted reproductive technologies are associated with an increased risk of major birth defects overall, the study found significant differences in risk between available treatments.
• The study included conceptions by all available techniques: IVF, intra-cytoplasmic sperm injection (ICSI), and Gamete intra-fallopian transfer, or GIFT, among others.
• There was considerable variation by technique. With ICSI, now the most commonly used of the invasive techniques, there was an increased risk associated with fresh embryos, though not with frozen ones, even after adjusting for other factors.

For more information go to: http://www.nytimes.com/2012/05/15/health/research/birth-defect-risk-higher-with-fertility-treatments-study-shows.html?_r=0