ArticleHuman reproduction open2019
Worldwide decline of IVF birth rates and its probable causes.
Article in Human reproduction open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 73 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
73 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Effects of the commercial Chinese polyherbal preparation Zishen Yutai Pill on the pregnancy outcomes in women undergoingFrontiers in pharmacology · 2026Pooled it
- Economic evaluations of assisted reproductive technologies in high-income countries: a systematic review.Human reproduction (Oxford, England) · 2024Pooled it
- A comprehensive analysis of chromosomal polymorphic variants on reproductive outcomes after intracytoplasmic sperm injection treatment.Scientific reports · 2023Pooled it
- Regular (ICSI) versus ultra-high magnification (IMSI) sperm selection for assisted reproduction.The Cochrane database of systematic reviews · 2020Pooled it
- Effect of single blastocyst-stage versus single cleavage-stage embryo transfer on cumulative live births in women with good prognosis undergoing in vitro fertilization: Multicenter Randomized Controlled Trial.Nature communications · 2024Trial
- Transcutaneous electrical acupoint stimulation improves endometrial receptivity resulting in improved IVF-ET pregnancy outcomes in older women: a multicenter, randomized, controlled clinical trial.Reproductive biology and endocrinology : RB&E · 2022Trial
- A randomised controlled trial to assess the clinical effectiveness and safety of the endometrial scratch procedure prior to first-time IVF, with or without ICSI.Human reproduction (Oxford, England) · 2021Trial
- Improved clinical outcomes after non-invasive oocyte selection and Day 3 eSET in ICSI patients.Reproductive biology and endocrinology : RB&E · 2021Trial
- Ultra-low oxygen tension duringbioRxiv : the preprint server for biology · 2026Article
- Effects of repeated ovarian hyperstimulation on gut microbiota composition in a mouse model.JBRA assisted reproduction · 2026Article
- Endometriosis at the Single-Cell Level: Molecular Insights and Implications for Assisted Reproduction Success.Biomolecules · 2026Review
- Commercial Impacts on Assisted Reproductive Technology: A Scoping Review.Journal of bioethical inquiry · 2026Article
- Clinical Outcomes of ICSI Using Advanced Quantitative Phase Microscopy.Bioengineering (Basel, Switzerland) · 2026Article
- Don't panic? Or don't conflate?Human reproduction open · 2026Article
- The declining efficiency of IVF in the USA.Human reproduction open · 2026Article
- Pituitary-derived Follicle stimulating hormone has greater follicle-stimulating bioactivity than recombinant Follicle stimulating hormone possibly due to glycoform variants†.Biology of reproduction · 2025Article
- Linear association between endometrial thickness and live birth in single blastocyst transfers: A dual-center retrospective cohort study.Acta obstetricia et gynecologica Scandinavica · 2025Article
- Effect of Chinese Herbal Medicine on Pregnancy Outcomes in IVF Patients with Low Ovarian Reserve: A Predictive Model.Medicina (Kaunas, Lithuania) · 2025Article
- Private equity and reproductive medicine: "Fertile breeding ground" - a physician's perspective".Reproductive biology and endocrinology : RB&E · 2025Review
- Harnessing vaginal inflammation and microbiome: a machine learning model for predicting IVF success.NPJ biofilms and microbiomes · 2025Article
13 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
With steadily improving pregnancy and live birth rates, IVF over approximately the first two and a half decades evolved into a highly successful treatment for female and male infertility, reaching peak live birth rates by 2001-2002. Plateauing rates, thereafter, actually started declining in most regions of the world. We here report worldwide IVF live birth rates between 2004 and 2016, defined as live births per fresh IVF/ICSI cycle started, and how the introduction of certain practice add-ons in timing was associated with changes in these live birth rates. We also attempted to define how rapid worldwide 'industrialization' (transition from a private practice model to an investor-driven industry) and 'commoditization' in IVF practice (primary competitive emphasis on revenue rather than IVF outcomes) affected IVF outcomes. The data presented here are based on published regional registry data from governments and/or specialty societies, covering the USA, Canada, the UK, Australia/New Zealand (combined), Latin America (as a block) and Japan. Changes in live birth rates were associated with introduction of new IVF practices, including mild stimulation, elective single embryo transfer (eSET), PGS (now renamed preimplantation genetic testing for aneuploidy), all-freeze cycles and embryo banking. Profound negative associations were observed with mild stimulation, extended embryo culture to blastocyst and eSET in Japan, Australia/New Zealand and Canada but to milder degrees also elsewhere. Effects of 'industrialization' suggested rising utilization of add-ons ('commoditization'), increased IVF costs, reduced live birth rates and poorer patient satisfaction. Over the past decade and a half, IVF, therefore, has increasingly disappointed outcome expectations. Remarkably, neither the profession nor the public have paid attention to this development which, therefore, also has gone unexplained. It now urgently calls for evidence-based explanations.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.