Assisted reproduction is increasingly available to infertile and sub-fertile people in the developed countries and in many developing countries (also referred to as "low resource settings"). Correspondingly, the sophisticated treatment regimens associated with assisted reproduction are being applied to an expanding population of otherwise healthy infertile people.
As a result, questions have been raised on the effectiveness, safety, availability and costs of these procedures, as well as the many ethical and legal aspects of their use. It is therefore understandable that the practice of assisted reproduction and its clinical outcomes have been reported extensively in the literature during the last decade. However, most of these reports have come from individual clinical centers and are based on relatively small numbers of patients. Therefore, the applicability of specific results and outcomes from such small and highly selected patients to the general populations seeking treatment is limited.
During its infancy, assisted reproduction was only available at a small number of specialized research institutions worldwide. Individual clinical experiences could be exchanged through the scientific literature, international conferences or informal communication among the well-known clinical centers. With the increase in both the number of clinics providing these techniques and the number of patients receiving treatment, more rigorous data collection has become necessary.
Data Collection Rationale
To understand better the scope and impact of assisted reproduction, public health agencies and medical societies worldwide have established or soon will establish national surveillance systems for these technologies.
The collection of data on the outcomes and possible adverse effects of assisted reproductive techniques can assist:
The collection and pooling of data on assisted reproduction occur at different levels for different purposes:
Data Collection Methodology
Data collection and data handling can be done following either of two strategies:
The USA and Sweden initially adopted the first strategy, but switched over to the second strategy. The UK, Germany, France, Australia and New Zealand have followed the second strategy for the duration of their ART collection. It is obvious that the second strategy leads to a more sophisticated and serviceable database, but the additional cost must be considered.
Published data need to meet the demands of the ART professionals and the public. The information needs to be interpreted and presented with relevant professional comments to avoid misinterpretation. Publication of crude (unadjusted) pregnancy rates from individual centers alone cannot be the primary goal of an international registry. Indeed, such presentations may not be in the best interest of the public.
A major accomplishment of any international working group, therefore,
should be to define standard definitions and methods for presenting
information, thereby facilitating interpretation and inference. ICMART has
done this most recently in cooperation with the World Health Organization
(WHO). ICMART is a non-governmental organization (NGO) in official relations
Honorary Past Chair
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