Trends in Live Birth Rates Attributable to Assisted Reproductive Technology in British Columbia
Trends in Live Birth Rates Attributable to Assisted Reproductive Technology in British Columbia
We will examine trends in ART use in BC specifically. The use of ART has drastically changed
 the management of infertility, with worldwide estimates exceeding 1.8 million ART cycles in
 2010 alone. Moreover, an excess of six million children have been conceived using ART.
 Although various countries have published their live birth rates associated with common ART
 treatment strategies, British Columbia has yet report on its rates. With varying differences
 in ART practices, whether clinical or laboratory, one would expect live birth rates due to
 ART to vary depending on region analyzed. Analyzing the live birth rate in BC would not only
 allow for a benchmark for assessing future improvement, and trends in infertility diagnosis
 and management, but also allow for comparison to other provinces and countries. The aim of
 this part of the study is to describe ART cycle contribution to live birth rate in BC from
 April 2008 to March 2018, which has not been addressed in the literature as of yet. Not only
 will it give healthcare providers and patients information about this emerging approach to
 infertility but also provide a impetus for healthy policy makers to adopt a model for
 partially or fully publicly funded ART, as seen in Ontario and soon Quebec.
Perinatal Services BC maintains a current database on live births, antepartum, intrapartum
 and postpartum outcomes; including details of ART if used to conceive. Live birth rate, for
 the purposes of this study, will be defined as the birth of at least one live born baby, with
 the birth of twins or higher order multiples considered as one live birth. The birth rate for
 ART will be taken as a proportion for birth rate from ART over total birth rate for given
 calendar year and the overall period of analysis. Data from April 1 2008 to Marcch 31 2018 on
 autologous ART treatment cycles and outcomes will be extracted from this database, with
 approval. Overall proportion of ART contributing to live birth rate will be analyzed as well
 as sub categorical analysis based on age (younger than 30, 30-34 years, 35-39 years, 40-44
 years, and 45 years and older). Only nulliparous women will be included in this study. All
 Moreover, data will be analyzed by calendar year in which baby from ART delivered to evaluate
 overall trends in ART outcomes. The total live birth rate for all of BC will serve as the
 denominator.

 Although the data will be reviewed and rules interpreted by the principal investigator of
 this study, a biostatistician will be hired to carry out the necessary statistical analysis.
Inclusion Criteria:

 -  Nulliparous women registered in Perinatal Services BC database with live birth between
 April 2008 and March 2018

 Exclusion Criteria:

 -  multiparous women

 -  women with missing data in Perinatal Services BC database including gravid, parity,
 age, date of birth