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’ Supplement Article IFFS Surveillance 2019 The International Federation of Fertility Societies (IFFS) is a federation of national membership societies that have an interest in the clinical and research aspects of reproduction and fertility. IFFS is a non-governmental organization (NGO) in official relations with the World Health Organization (WHO). Copyright 2019 by International Federation of Fertility Societies (IFFS). All rights reserved. No part of this publication may be repro- duced by any means without the prior written consent of the IFFS. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the IFFS concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. The editorial board members and survey respondents are responsible for the views and comments, respectively, expressed in this publication and they do not necessarily represent the decisions, policy, or views of the IFFS. Copyright © 2019 The Authors. Published by Wolters Kluwer on behalf of the International Federation of Fertility Societies. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial- No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Global Reproductive Health (2019) 4:e29 http://dx.doi.org/10.1097/GRH.0000000000000029 1 IFFS Surveillance 2019. Global Reproductive Health (2019) 4:e29 Global Reproductive Health PREFACE questions, and this is reflected in the variations in amount of data submitted for the individual queries. The percent positive Table of contents response is given for all answers, for that particular query. For specific questions, participants could answer “yes’, “no” or 1. Number of centres “unknown” if the respondent did not know the answer to a 2. Legislation and policy guidelines particular query. 3. Insurance coverage Many individuals contributed to the success of this project. I 4. Marital status and same sex and single parenting policy am profoundly grateful for the efforts of the 191 respondents, 5. Number of embryos for transfer in assisted reproductive representing 97 countries, who completed the survey. The ques- technology (ART) tionnaire is lengthy, and the answers to some questions are not 6. Cryopreservation readily accessible. The diligence and commitment of a wide array 7. Posthumous reproduction of colleagues around the world was essential to the successful 8. Donation and anonymity of donors completion of the publication. 9. Oocyte maturation Although Surveillance 2019 is a global project, relying on 10. Micromanipulation many individuals from many nations, the ultimate success in 11. Welfare of the child and identity rights engaging such a diverse representation hinged on personal rela- 12. Fetal reduction and sex selection tionships. To this end, many IFFS officers and representatives 13. Preimplantation genetic testing gave generously of their time, contacting and enlisting many 14. Surrogacy international colleagues who were new to Surveillance. I would 15. Cross border reproductive care particularly like to acknowledge the efforts of Drs. Silke Dyer and 16. Human pre-implantation embryo research Fernando Zegers, who issued countless personal appeals; they 17. Status of the embryo deserve a large share of the credit for the increased representation 18. Conclusions this year. Closer to home, our administrative assistant, Leila Grass, resorted to extensive social media searches to identify ART PREFACE centres in countries that we had previously been unable to engage; her efforts were ultimately successful. The Surveillance Editorial The triennial Surveillance project, initiated in 1998 by Drs. Board worked tirelessly; all had roles in developing the 2018 Howard Jones, Jr and Jean Cohen, continues to evolve, now with questionnaire, reformatting the organization of Surveillance, and a new name, the International Federation of Fertility Societies’ conducting data analysis, and were also involved in chapter Surveillance (IFFS) 2019: Global Trends in Reproductive Policy preparation and editing. and Practice, 8th Edition. The new name more accurately reflects Special recognition is due Drs. Edgar Mocanu and Marcos the scope and focus of the project, and makes the report more Horton. The Assistant Editor, Dr. Horton, worked relentlessly, as accessible to a global audience, particularly those seeking this he did in previous editions, and was particularly invaluable in this information online. IFFS is a non-state actor (NSA) in official capacity. Our Managing Editor, Dr. Kathleen Miller, deserves the relations with the World Health Organization (WHO), and the greatest accolades for her passionate pursuit of a comprehensive, publication of Surveillance serves as part of the IFFS’ WHO high-quality product. Finally, I would like to recognize the con- mandate. tinuing support, encouragement, and participation of the IFFS The 2019 version has several major changes. Some chapters officers and Board of Directors, and the administrative staff of the have been expanded, and some topics have been combined to IFFS Secretariat, for their essential roles in the project’s successful eliminate redundancies. The number of chapters has been completion. reduced from 24 to 18, but all previous topics and questions have Surveillance 2019 presents a more comprehensive global been retained. assessment of the status of reproductive policy and practice than The 2018 online questionnaire was the sole source of data for previous editions, drawing input from 97 of the 132 countries IFFS Surveillance 2019: Global Trends in Reproductive Policy believed to offer ART services. Data collection was improved by and Practice, 8th Edition. The online questionnaire was further further refinements in the questionnaire, a more robust process refined, and was again administered by Medtech for Solutions®. for identifying and engaging prospective participants, and many The refined questionnaire consisted of 94 questions, in English, local and regional developments that facilitated cooperation and with translated versions available. On average, it took 90 minutes participation. Consequently, Surveillance 2019 depicts a further (cumulative on-site time) to complete. The survey was accessible maturation of the field, with wide adoption of technologic online from February 1 through March 31, 2018. advances, and an emerging consensus regarding some of the more Although a few responses were accepted shortly after the controversial aspects of ART. deadline, they reflect the practices of assisted reproductive tech- Significant limitations remain, however. Although the report nology (ART) (also called assisted reproductive treatment) refers to practices and policies of countries, responses for most of through that time. Respondents representing 97 countries (22 the participating countries were provided by a single well- more than in 2015) registered online at the website, and all informed, responsible individual. The responses have not been provided at least some responses to the 2018 questionnaire, validated for the majority, and may include inherent inaccuracies. enough to be included in the analysis. There were 27 more usable Some respondents were not able to provide complete data sets. responses than in the 2015 survey, in which 26 responses Some ART practices have undoubtedly changed since the survey were new to Surveillance. Responses were not received for all was completed and answers may not reflect current practices. For 2 IFFS Surveillance 2019. Global Reproductive Health (2019) 4:e29 these reasons, caution should be exercised in interpreting the Preface. Table 1 data. When feasible, responses from previous triennial surveys (Continued) and multiple respondents have been compared. When dis- Participant Name Participant Country crepancies were identified among multiple respondents, or from Anibal Scarella Chile other published reports, the editors adjudicated the incon- Oscar Espinosa Chile sistencies. However, this occurred infrequently. Liangzhi Xu China IFFS Surveillance 2019: Global Trends in Reproductive Policy Eduardo Castro Valderrama Colombia and Practice, 8th Edition is unique in its depiction of world-wide Ricardo Rueda Colombia ART policy and practice. This report attests to the dynamic, Delia Ribas Valdes Costa Rica ongoing growth of the practice of ART, the local and regional Pavel Ventruba Czechia differences, and the continued international collaboration that Ventruba Pavel Czechia has characterized the field since its inception (Table 1). Verona Blumenauer Deutschland Victor Montes De Oca Dominican Republic Justin Mboloko Esimo Congo Steven J Ory Pablo Valencia Ecuador Editor-in-Chief Hassan Sallam Egypt Surveillance 2019 Mostafa Fouad Gomaa Egypt December 2018 Taymour Mostafa Egypt Walid Sherbiny Egypt Jose Roberto Bonilla Henriquez El Salvador Preface. Table 1 Deniss Soritsa Estonia Participants. Liisa Kuusipalo Finland Nathalie Massin France Participant Name Participant Country Lia Chkonia Georgia Nigri Kamal Algeria Charles Senaya Ghana A. Gustavo Martinez Argentina Michael B. Yakass Ghana Antonio Sarra Pistone Argentina Asimakis Pappas Greece Fabian Lorenzo Argentina Jose Rodrigo Salguero Ruata Guatemala Ester Polak de Fried Argentina Raymond
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