Rita Vassena, Luis Martínez Granados, Luis Gijón Tévar, María Lourdes Sánchez Castro, Yolanda Cabello, Ana Belén Castel Segui, Rafael Lafuente Varea, Juan Fontes Jiménez, María Jose de los Santos, Julio Herrero, Ignacio Rodríguez, Belén Acevedo Martín, Rafaela González Castillo, Raquel Urteaga García, María Cruz Palomino, Luis M García Martín, Jose Antonio Castilla, Fernando J Prados, Irene Cuevas, on behalf of the Registry Committee of the Spanish Fertility Society (SEF)
JBRA Assist. Reprod. - Advanced View
Received June 24, 2026
Accepted June 29, 2026
Abstract
Objective: To document IVF/ICSI and intrauterine insemination (IUI) activity in Spain during 2020–2022 using the Spanish Fertility Society National Activity Register (RNA SEF), assessing pandemic disruption, recovery and sector resilience in one of Europe’s largest providers of assisted reproductive technologies (ART). The first pandemic year brought major healthcare disruptions; 2021 represented controlled, orderly recovery of most activity, and 2022 reflected a more stable pattern with activity returning to pre-pandemic levels.
Methods: Annual center-level aggregated data, rather than individual cycle or patient records, were analyzed from 242/249/248 centers. All numerical sequences below correspond chronologically to 2020, 2021 and 2022, respectively. The registry captured annual treatment activity across participating Spanish centers, allowing comparisons between these three years. Cycle counts were: fresh own oocytes, 37,782/46,224/42,341; fresh donor oocytes, 12,001/13,287/12,590; cryopreserved embryos, 27,571/37,310/36,235; preimplantation genetic testing (PGT), 13,153/17,828/20,502; cryopreserved oocytes, 8,171/11,179/11,738; and IUI, 24,816/33,818/31,635.
Results: Fresh own-oocyte IVF/ICSI yielded 5,434/6,353/5,461 clinical pregnancies, with pregnancy rates per fresh transfer of 34.5%/34.4%/34.6% and multiple-pregnancy rates of 10.5%/10.0%/9.0%. The latter continued a decade-long decline, falling below 10% for the first time. Fresh donor-oocyte transfers numbered 5,065/5,730/5,102, yielding 2,912/3,363/2,901 clinical pregnancies; pregnancy rates were 57.5%/58.7%/56.9%, and multiple-pregnancy rates were 10.3%/9.2%/7.8%. PGT cryotransfers numbered 7,293/10,191/12,256, yielding 3,813/5,400/6,371 pregnancies, with rates of 52.3%/53.0%/52.0%. Transfers using vitrified own oocytes numbered 541/712/677, versus 5,225/7,021/7,288 using vitrified donor oocytes. IUI comprised 13,465/17,593/16,575 partner-sperm cycles (IUI-H) and 11,351/16,225/15,060 donor-sperm cycles (IUI-D), with overall pregnancy rates per cycle of 15.7%/16.5%/16.1%.
Conclusions: Following substantial pandemic-related disruption affecting public and private ART services in 2020, all cycle categories rebounded in 2021. Most declined moderately in 2022, whereas PGT and cryopreserved-oocyte cycles increased throughout. Activity returned to pre-pandemic levels, reflecting recovery and adaptation. Pregnancy rates remained broadly stable, while declining multiple-pregnancy rates indicated improving safety. These findings document the sector’s resilience during an extraordinary national public health challenge.
