Relevance of International Committee for Monitoring Assisted Reproductive Technology (ICMART) Registry report 2011 - Fertility and Sterility

The International Committee for Monitoring Assisted Reproductive Technology (ICMART) promotes and develops national and regional ART registries to monitor safety and efficacy in ART treatment worldwide. This is the 16th ICMART World Report and the most comprehensive global ART statistical report using aggregate country data (1x1Adamson, G.D., de Mouzon, J., Chambers, G.M., Zegers-Hochschild, F., Mansour, R., Ishihara, O. et al. International Committee for Monitoring Assisted Reproductive Technology: world report on assisted reproductive technology, 2011. Fertil Steril. 2018; 110: 1067–1080 Google ScholarSee all References)(1). Despite the remarkable task of coordinating, executing, and completing such an endeavor, there are obvious limitations of the current registry report, as pointed out by the authors. Not using cycle- or patient-specific data calls into question the accountability of the collected data. Clinically important data such as day of embryo transfer are missing, which impacts the accurate interpretation of pregnancy and live-birth outcomes. The absence of recording all cycle starts inflates the success rates. And reporting these findings 7 years after the fact gives rise to doubt about their relevance, as much has changed in clinical and laboratory practice since 2011. As a clinician practicing in the United States in 2018, I fully acknowledging all these limitations in the report, and I ask myself two questions. First, is this report relevant to clinicians practicing in the world today? And, second, does this report inform our understanding of the strengths and limitations of our current national practice patterns as reflected by the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System (SART CORS) registry? The short answer is “yes” to both these questions. First, let's explore the initial question. This specific report is a snapshot of many heterogeneous countries and cultures that practiced ART in 2011. It has relevance to present day because it provides a glimpse into the different current medical systems. These systems reflect a variety of cultures, belief systems, degrees of religiosity, and values. Each system contends with varying degrees of third-party economic support (government, insurance, employer, etc.) and resources directed to women's health care in general. Each of these different parameters most likely affects access to care, the physician–patient relationship, and the choices made by each party, all of which vary from region to region. Hence, it is expected, as the authors conclude, that there