More diverse families created through IVF

Single women and female same-sex couples accounted for 1 in 5 IVF cycles in 2023, according to the latest report on IVF births across Australia and New Zealand.

“IVF is not just for treating infertility in heterosexual couples,” says Professor Georgina Chambers, Director of UNSW’s National Perinatal Epidemiology and Statistics Unit (NPESU). “It is increasingly enabling individuals who need medically assisted fertility treatment to build their own families—regardless of relationship status or sexual orientation,” she says.

Prof. Chambers is lead author of the 2023 Australian and New Zealand Assisted Reproduction Database (ANZARD) report, which is the most recent year for which complete IVF data are available.

There were 20,417 babies born in Australia and New Zealand that year with the help of IVF, which is a similar number to the previous year. This translates to 1 in every 16 births in Australia, with 1 in every 8 births being to women aged 35 years and older. In New Zealand, the overall rate is 1 in 27 births.

Solid numbers

More than 109,000 cycles were performed in Australia and New Zealand in 2023—an increase of 3.6% from 2022. Of these, 14.6% involved single women and 4.4% involved female–female intended parents.

“We observed a steady increase in the diversity of individuals creating families using IVF, particularly single women,” Prof. Chambers says. “The number of IVF cycles undertaken by single women surged from nearly 9,500 in 2020 to 15,994 in 2023.

“Similarly, 3,648 IVF cycles in 2020 were undertaken by female same-sex couples, increasing to 4,777 cycles in 2023.”

Prof. Chambers says the definition of infertility is being broadened to include individuals who can’t have children because of their relationship status or sexuality. “This updated definition of infertility is more inclusive and equitable and is reflected in our IVF statistics,” she says.

Dr. Petra Wale, President of the Fertility Society of Australia and New Zealand (FSANZ), says “Individuals without partners or those in same-sex partnerships need to use donor sperm or eggs during IVF.”

In 2023, about 60 cycles involved egg or embryo donation to single men or same-sex male intended parents, with surrogacy support as part of the process. More than 100 births came from 405 surrogacy arrangement cycles.

“Surrogacy provides many people with a pathway to parenthood, using eggs or sperm from either the intended parents or a donor,” Dr. Wale says. “As demand for IVF continues to rise, these data point to a future where reproductive care is both more effective and inclusive than ever before.”

Further technology uptake

The use of fertility preservation—where all suitable eggs or embryos are frozen for future use—has also surged in recent years.

Preservation cycles surged to nearly 9,000 in 2023, up 28% from the previous year and more than twice the 2020 total. Within this, 712 fertility preservation cycles were undertaken by patients facing cancer treatment—a 22% increase from the 582 cycles performed in 2020.

However, the biggest increase was in planned egg freezing cycles, where women chose to freeze their eggs for future use. While this option may be medically advised for conditions like severe endometriosis, polycystic ovarian syndrome (PCOS) or diminished ovarian reserve, some women are also electing to freeze their eggs earlier in life. This safeguards their chances of having children later, when natural fertility declines.

The data also reflect advances in genetic testing. Nearly 10,000 cycles used preimplantation genetic testing (PGT)—a 14% rise from the previous year.

Half of all PGT embryo transfers resulted in a clinical pregnancy, with success rates highest among women in their early 30s.

Dr. Simon McDowell, Vice President of the FSANZ and subspecialist in Reproductive Endocrinology and Infertility, says PGT is primarily used to identify embryos with the correct number of chromosomes.

“This can improve the likelihood of success in an individual embryo transfer cycle,” Dr. McDowell says. “But whether PGT increases the overall chance of having a baby for each woman starting IVF treatment continues to be debated.”

Advances in safety

The data indicate IVF in Australia is still both safe and effective.

“Australia and New Zealand lead the world in minimizing health risks associated with multiple pregnancies by promoting single embryo transfer,” Prof. Chambers says.

Multiple pregnancies and births increase the risk of conditions such as preeclampsia, gestational diabetes, post-partum hemorrhage, pre-term birth and low birthweight.

In 2023, nearly 95% of transfers involved only one embryo, compared to 83% of transfers a decade ago. This method has driven multiple birth rates via IVF in Australia down to a record low of 2.2%, which is among the lowest globally.

Overall success rates have also improved. For the more than 40,000 women starting IVF between 2020 and 2021, almost 40% had a baby in their first complete IVF cycle.

Frozen embryos were used in 40% of cycles and continues to drive higher outcomes, with birth rates increasing from 29.7% in 2019 to 32.8% in 2023.

“The increasing use of frozen embryos supports the practice of transferring one embryo at a time, giving patients confidence that they can ‘bank’ on what’s in the freezer while keeping multiple birth rates at an all-time low,” Prof. Chambers says.

The live birth rate per initiated IVF cycle increased from 22.1% in 2019 to 23.8% in 2023.

The YourIVFSuccess Patient Estimator can help patients draw on the information of all IVF cycles performed in Australia to calculate their own chance of IVF success. Patients can enter data about their personal circumstances and treatment characteristics.

The website was recently updated to provide an overview of IVF use, success rates and trends. It will soon include an elective egg freezing calculator and more consumer resources.