In a revealing update presented at the 41st Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE), groundbreaking data on assisted reproductive technologies (ART) in Europe during 2022 have come to light. Despite a notable reduction in the total number of treatment cycles reported, clinical pregnancy rates have remained remarkably stable, signaling a nuanced evolution in reproductive healthcare across the continent. The European IVF Monitoring (EIM) Consortium, which aggregates this comprehensive data, underscores the complexities and advancements shaping fertility treatments amid changing demographic and clinical practice landscapes.
The data reveals that in 2022, a total of 960,347 ART cycles were performed across 39 European countries, representing a 15.6% decrease when compared to the 1,137,177 cycles reported in 2021. This decline prompts critical reflection on potential underlying factors, including shifting healthcare policies, access constraints, economic fluctuations, and patient choices. However, within this overall reduction, the persistence of clinical pregnancy rates emphasizes that the quality and effectiveness of these treatments remain uncompromised, reflecting sustained clinical proficiency and possibly improved patient selection criteria.
Delving deeper into the treatment modalities, the report categorizes the ART cycles into several key types: in vitro fertilisation (IVF), intracytoplasmic sperm injection (ICSI), frozen embryo transfers (FET), preimplantation genetic testing (PGT), and oocyte donation (OD). In 2022 alone, IVF accounted for 137,148 cycles, while ICSI constituted a larger segment with 317,415 cycles. Frozen embryo transfers were notably the most prevalent, with 365,905 cycles undertaken. The rise of FET is indicative of the increasingly common “freeze-all” approach, an evolving clinical practice aimed at improving endometrial receptivity and optimizing pregnancy outcomes.
The incorporation of preimplantation genetic testing into standard practice also remains significant, with 92,677 cycles documented. PGT technology facilitates the selection of embryos free from specific genetic abnormalities, thereby increasing the likelihood of successful implantation and miscarriage reduction. The availability of oocyte donation cycles, tallying 41,138 in the reported period, reflects ongoing reliance on donor gametes to address a variety of infertility issues including diminished ovarian reserve and advanced maternal age, underscoring the critical role of third-party reproduction.
Parallel to ART, intrauterine insemination (IUI) continues to be an essential fertility intervention, with 126,185 cycles utilizing partner semen and an additional 42,532 cycles employing donor semen. IUI’s less invasive approach retains its relevance, particularly for couples with unexplained infertility or mild male factor issues. Additionally, the emerging sphere of fertility preservation interventions, encompassing oocyte, ovarian tissue, semen, and testicular tissue banking, registered 30,758 cases across 14 countries. This facet of reproductive medicine addresses the growing needs of oncology patients and individuals opting to preserve fertility ahead of potentially gonadotoxic treatments or personal life choices.
Crucially, despite the quantitative fluctuations in cycle numbers, clinical pregnancy rates have exhibited remarkable stability between 2021 and 2022. IVF pregnancy rates per aspiration and per transfer experienced only marginal decreases, from 26.3% to 25.8% and 33.5% to 32.7% respectively. Similarly, ICSI maintained rates around 24% per aspiration and 32-33% per transfer. Frozen embryo transfers, often regarded as more patient-friendly and physiologically congruent, showed a slight dip from 37.0% to 36.6%. These data points collectively highlight that patient outcomes in assisted reproduction have not been compromised despite fewer cycles being performed.
A striking trend illuminated by the data is the continued rise in the use of single embryo transfer (SET), increasing from 60.5% in 2021 to 62.6% in 2022. The migration towards SET is largely driven by the imperative to reduce multiple gestations, which pose heightened risks for both maternal and neonatal complications. Correspondingly, singleton delivery rates improved to 91.5%, while twin deliveries declined to 8.4%, and triplet deliveries maintained a low prevalence at 0.1%. This shift reflects a growing consensus within the reproductive medicine community that prioritizes safety and long-term health in ART pregnancies.
Professor Dr. Diane De Neubourg, Chair of the EIM Consortium, emphasized the implications of these findings, highlighting that “the report confirms the continued high utilisation of ART and IUI across Europe.” Despite the modest decrease in cycle numbers, stable pregnancy rates and rising singleton birth prevalence collectively demonstrate advances in clinical protocols and patient management. Notably, the magnitude of this dataset — with nearly one million treatment cycles annually — provides an unparalleled resource for transparency, quality assurance, and vigilance in reproductive healthcare.
Echoing these sentiments, Professor Dr. Karen Sermon, Chair of ESHRE, underscored the importance of rigorous and harmonized data collection across diverse European healthcare systems. She noted that “strengthening standardised reporting drives improvements in care quality and outcome for patients undergoing medically assisted reproduction.” This highlights the ongoing need to refine registries and reporting methodologies in order to capture nuanced details that inform clinical best practices and policymaking in an evolving reproductive landscape.
The ESHRE EIM Consortium report, representing the largest aggregation of assisted reproduction data in Europe since 1997, is a cornerstone for examining longitudinal trends and informing future clinical and regulatory strategies. With nearly 14 million ART treatments recorded to date and approximately 2.8 million children born through these technologies, the consortium’s efforts provide an indispensable lens into how reproductive medicine is developing on a continental scale.
Nonetheless, the authors advise caution in interpreting the findings, acknowledging considerable heterogeneity among European countries in terms of data completeness and collection methodologies. Variability in reporting standards, clinical practices, and health system infrastructures present challenges for direct cross-national comparisons but do not diminish the report’s critical role in identifying broad patterns and informing harmonization efforts.
This evolving portrait of ART in Europe captures a mature yet dynamic field combining cutting-edge biomedical science with tailored clinical strategies. The increased reliance on single embryo transfer, coupled with stable clinical pregnancy rates despite lower overall cycle numbers, epitomizes a shift towards safer, patient-centered fertility treatment. Furthermore, the expansion into fertility preservation signals an awareness of reproductive health beyond traditional infertility paradigms, integrating oncology, gender diversity, and elective preservation into the reproductive medicine fold.
As reproductive technologies become ever more sophisticated, this comprehensive European data offers invaluable benchmarks to propel medical innovation and optimize patient care. The findings presented at the ESHRE 41st Annual Meeting not only reinforce the efficacy of current treatments but also catalyze dialogue on how healthcare systems can adapt to patient needs while ensuring rigorous quality and ethical standards. The depth and breadth of the report showcase the power of collaborative registries and scientific exchange in shaping the future of human reproduction.
Subject of Research: Assisted Reproductive Technology (ART) and Intrauterine Insemination (IUI) trends and outcomes in Europe during 2022.
Article Title: — [Not explicitly provided]
News Publication Date: 1 July 2025
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References:
- Presentation “Assisted Reproductive Technology (ART) in Europe 2022 and development of a strategy of vigilance: Preliminary results generated from European registers by the ESHRE EIM Consortium.” Presented at the ESHRE 41st Annual Meeting, 1 July 2025.
- ESHRE European IVF Monitoring (EIM) Consortium reports since 1997, published in Human Reproduction.
- Smeenk, J., et al. (2024). Assisted reproductive technology (ART) in Europe 2021 and development of a strategy of vigilance: Preliminary results generated from European registers by the ESHRE EIM Consortium. Human Reproduction, 39(Suppl_1).
- Clinical pregnancy definition per ultrasound confirmation of gestational sac or clinical signs.
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Keywords: Human reproduction; Human fertilization; In vitro fertilization; Pregnancy; Birth control; Human biology; Human health
