[Publication of the results in all Dutch centers for in vitro fertilization: an important step towards an improvement in the effectiveness of the treatment].
For the first time, the results from all 13 in vitro fertilisation (IVF) centres in the Netherlands have been published in the scientific literature. The Dutch IVF system is unique in many respects, especially with regard to the limited number of high-volume centres, the widespread use of transport IVF and the complete coverage by health insurance companies. IVF is frequently applied, resulting in an amazing I IVF child out of every 60 children born in the Netherlands. The reported ongoing pregnancy rates per started IVF cycle (21%) are comparable with those in other European countries, but lower than in the United States. However, the number of embryos transferred is relatively low (a maximum of 2), resulting in a very low risk of higher order multiple pregnancies. Even twin pregnancies remain the most dangerous health issue associated with IVF. In order for IVF to move forward, a shift in paradigms is urgently required. The surrogate endpoint of 'pregnancies per treatment cycle' should be replaced by the alternative measure of 'healthy children born per started IVF treatment' in relation to patient discomfort, side effects, chances for (long-term) health risks, and costs.
Fauser
B C J M
BC
Erasmus Medisch Centrum, Centrum voor Voortplantingsgeneeskunde en afd. Verloskunde en afd. Verloskunde en Vrouwenziekten, Dr. Molewaterplein 40, 3015 GD Rotterdam. fauser@gyna.azr.nl
D005060:Europe; D005260:Female; D005307:Fertilization in Vitro / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D009426:Netherlands; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data; D014481:United States