Medically-assisted reproduction in Italy, 2021 data from the Italian MAR Registry.

Background: The Italian Medically Assisted Reproduction Registry (ItMARR) was established by a Decree of the Minister of Health issued on October 7, 2005. ItMARR has a crucial role in clearly and publicly disseminating epidemiological information on MAR activities and outcomes.

Methods: ItMARR data are collected in aggregate form and their submission is mandatory as stipulated by Law 40/2004. The aim of this article is to make a comprehensive overview of the activity of authorized centers that perform IUI and ART in Italy. Data used in this article refer to MAR treatments started between January 1 and December 31, 2021.

Results: MAR techniques were performed by 340 centers. In total, 92,407 ART cycles and 15,660 IUI cycles were performed in 2021. Gametes donation cycles represent 14.6% of ART activity and 4.2% of IUI. ART cycles performed per million women of childbearing age were 9077. In 2021, 3.8% of births in the general population in Italy were a result of ART application. In 2021, MAR activity had a strong increase compared to the previous year in which there were strong limitations on reproductive treatments due to the COVID-19 pandemic. Pregnancy rates per transfers were 29.4% with fresh techniques, 35.2% with FER, 26.3% with FO, 41.2% with OD and 37.9% with SD. The decreasing trend of multiple deliveries continues.

Conclusions: The ItMARR has become a great asset in the reproductive health scenario promoting a better MAR information dissemination. ItMARR is working on the implementation towards a "cycle-by-cycle" data collection system. This will bring the Italian monitoring system in line with others European countries.