P-743 Is the use of IVF in Australia appropriate?

Abstract Study question How often is ART treatment necessary and what is the true demand of ART treatment in Australia, as opposed to the published ART use? Summary answer The use of ART in Australia, as reported by ANZARD, exceeds the estimated demand of couples requiring ART treatment by 59%. What...

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Bibliographic Details
Published in:Human reproduction (Oxford) 2022-06, Vol.37 (Supplement_1)
Main Authors: Mazi, M, Temple-Smith, P, Mol, B
Format: Article
Language:English
Online Access:Get full text
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Summary:Abstract Study question How often is ART treatment necessary and what is the true demand of ART treatment in Australia, as opposed to the published ART use? Summary answer The use of ART in Australia, as reported by ANZARD, exceeds the estimated demand of couples requiring ART treatment by 59%. What is known already ART has gained increasing attention over the years in high resourced settings allowing easier access to this technology. The use of IVF and ICSI has become a standard treatment for infertility, with Australia having a high utilisation rate of ART. During the last decade, infertility treatments have been applied to all types of infertility, including unexplained subfertility. This trend has resulted in the possible over-treatment of couples that have a reasonable chance of natural conception. We used modelling to determine whether over- or under-servicing of ART is occurring. Study design, size, duration A model-based approach in which we estimated the annual demand for ART based on a calculated population suffering from infertility. This estimate number of couples requiring ART was then compared to Australia’s reported ART usage, to determine if over- or under-servicing is present in the country. The demand for ART was estimated using demographic data from the Australian New Zealand Assisted Reproduction Database (ANZARD), Australian government databases and literature. Participants/materials, setting, methods The initial assumptions included an estimate of the total infertile population in Australia based on demographic data, with an infertility rate of 10% or 16% (sensitivity) and the prevalence of infertility types obtained from literature. A treatment model was based on three categories (couples with “absolute indications requiring ART”, anovulatory and unexplained infertility).The sum of couples that conceived without ART and those unable to requiring ART was estimated and compared to the ANZARD report. Main results and the role of chance Following the model calculations and based on 305,800 live births and 15,150 ART deliveries, and assuming an infertility rate of 10%, the total infertile population was approximately 40,700 couples. It was estimated that an average of 27,300 couples was calculated to need ART treatment in Australia in 2019. Out of these couples, 58% indicated absolute indications for ART (including uni- and bilateral tubal obstruction and severe male infertility), 14% were couples with anovulatory infertility (couples dia
ISSN:0268-1161
1460-2350
DOI:10.1093/humrep/deac107.688