For couples with an unfulfilled desire to have children, patients, the public

We are pleased to make this special edition available to you as an excerpt from the large 2025 yearbook of the German IVF Register (D·I·R)®. It is aimed at all couples with unwanted childlessness, at all couples who are currently undergoing fertility treatment and also at the general public.

This special edition contains the most important nationwide figures for fertility treatments in the member centers of the German IVF Register. Here you will find the cycle outcomes of 2025 and the pregnancy outcomes of the treatment cycles of 2024.

Contents of this special edition

For one in six couples, the path to having the child they want is not possible naturally, but requires medical help. The German IVF Register (D·I·R)® always provides up-to-date figures, data and the results of fertility treatments in Germany by continuously evaluating treatment data from fertility centers.

Once a year, the D·I·R® publishes its large and comprehensive yearbook. This is aimed both at the public and at reproductive medicine and biologists. It therefore serves the experts for their own quality control, the exchange of experiences and the visualization of trends and improvements. In this special edition we have summarized, explained and commented on the most important key data and currently important topics especially for couples and the general public.

About the German IVF Register (D·I·R)®

The public wants information and transparency with regard to diagnostics and treatments in the sensitive area of ​​fertility medicine. This can only be achieved with a reliable and continuous evaluation of the treatment results from as many fertility centers as possible, such as the German IVF Register. In addition, this evaluation serves to provide scientific knowledge and the associated improvements in medical care and outcomes. But the evaluations of the German IVF Register are also important when it comes to advising and ultimately making decisions for couples who are involuntarily childless.

The German IVF Register (D·I·R)® is a non-profit association. This is a voluntary membership to which almost all fertility centers in Germany are affiliated and which therefore support and support our scientific evaluations, our research and the exchange of experiences. By evaluating the treatments and their results, the D·I·R® represents a unique treasure trove of data, which now contains almost 2.8 million treatments / almost 460,000 children born in Germany.

We would be pleased to have put together interesting and worth-knowing information for you in this special edition of the 2025 yearbook of the German IVF Register (D·I·R)®.

Your D·I·R® Board

ReproCheck: Individual forecasts at the touch of a button! “What are my chances?” – a common and central question about fertility treatment. The ReproCheck enables people who want to have children to get an initial but realistic picture of their individual prospects for success using simple input. Age, previous history and possible type of treatment are enough to better understand your own chances of pregnancy and birth as part of fertility treatment with just a few clicks.

The ReproCheck is aimed at couples before and during treatment. However, it cannot replace medical advice: the starting point for treating an unfulfilled desire to have children - and thus also the chances of pregnancy and birth - is always too individual and too dependent on the respective patient and the couple to be able to be shown in the ReproCheck. But it strengthens informed decision-making at a sensitive time in life. For many affected people, the ReproCheck offers valuable orientation in an emotionally challenging phase of life. It helps to classify expectations, prepare for discussions with treating doctors and make individual decisions more informed and together. The ReproCheck chances calculator does not replace medical advice, but is intended as a supplementary information offering.

The significance of the ReproCheck is based on an exceptionally high-quality data basis. Over 600,000 treatments from 2020 to 2024, recorded in almost all German fertility centers, are included in the calculations. This systematically collected and quality-assured registry data is reliable and representative of the actual supply situation in Germany. The ReproCheck gives couples a tool with which they can, for the first time, assess their chances realistically and on a scientific basis. Its strength lies in the quality and breadth of the data from the German IVF Register; they make the results reliable and relevant to everyday life.

More clarity when it comes to your desire to have children

A typical example shows what this can look like: A 35-year-old woman who is planning IVF treatment receives a differentiated assessment of her chances of pregnancy and birth, including the range of possible outcomes, based on comparable cases. Because: Especially for patients in their mid-30s, it is important to understand how individual factors affect the chances of success - or how the chances would gradually worsen if they waited a few more years of life. The ReproCheck can help to adjust expectations and to have more targeted conversations with doctors.

The ReproCheck is freely accessible, free of charge and user-friendly. Clear structures and understandable representations also make access easier for medical laypeople. Complex content is prepared in a comprehensible manner. The queries are not saved and always remain anonymous.

With this offer, the German IVF Register is providing an important impetus for more transparency and patient orientation in reproductive medicine - and is already developing the next generation!

Many couples hope to increase their chances of becoming pregnant when IVF treatment involves placing two embryos into the uterus at the same time. The rationale behind this is that if two embryos are transferred, there is a greater chance that at least one will implant. At the same time, however, the risk that both embryos will develop and a twin pregnancy will occur also increases. This very question has now been examined in more detail using data from the German IVF Register (D·I·R)®. In addition, the results were classified in an accompanying editorial by Prof. Heribert Kentenich.

For the study, data from more than 22,000 women who were treated in 133 German fertility centers between 2017 and 2022 were evaluated. Only women who had two well-developed blastocysts available on the day of embryo transfer were included. Two different treatment strategies were compared: either both embryos were transferred at the same time (double embryo transfer, DET) or only one embryo was inserted initially and - if no birth resulted - the second, previously frozen embryo was transferred at a later point in time (two consecutive single embryo transfers, SET + SET).

The results first show that a pregnancy is slightly more likely to occur immediately after a simultaneous transfer of two embryos than after a single embryo transfer. However, when considering the entire treatment including the subsequent transfer of the frozen embryo, slightly more women achieved a live birth after two consecutive single transfers than after a single transfer of two embryos. In other words, patience can pay off.

The most important difference, however, was in the safety of mother and child. After the transfer of two embryos, twin pregnancies occurred significantly more frequently. About every third birth after a double embryo transfer was a multiple birth, while this only happened very rarely after two consecutive single transfers. However, twin pregnancies are associated with significantly higher risks. The children are much more likely to be born prematurely, have a lower weight at birth and more often require intensive medical care. The risk of pregnancy complications such as high blood pressure or preeclampsia also increases for the mother. Exactly these differences were impressively confirmed in the registry analysis: premature births occurred more than twice as often after the transfer of two embryos as after two individual transfers.

In the accompanying editorial, Prof. Kentenich therefore emphasizes that the goal of modern fertility treatment should not only be pregnancy, but above all the birth of a healthy child. The study shows that this goal can often be achieved better if only one embryo is transferred at a time. At the same time, he points out that the legal framework in Germany has not always optimally supported this strategy and should therefore be further developed.

The results of this large registry study make it clear that a single embryo transfer with the possibility of a later transfer of the frozen second embryo can be a very good option for many couples. The chances of having a healthy child remain high, while the risk of twin pregnancies and associated complications decreases significantly. For many couples, this means that the common goal of fertility treatment should not be the fastest pregnancy, but rather the safest birth.

In 2024, 66,742 fresh cycles to obtain eggs and treat them were carried out in Germany. That's 140 cycles more than 2023.

An embryo transfer with a known cycle outcome occurred in 79.3% of cases.

The birth rate per transfer in 2024 was 22.3%, almost identical to 2023, while the multiple birth rate continued to fall significantly. This can be seen as a success of the single embryo transfer strategy.

While there were 1,017 twin births in 2023 (9.1%), this number fell to 727 twin births in 2024 (6.6% of all births)!

93.2% of births are now singleton births. Even though the multiple birth rate has fallen significantly at 6.7% overall, it is still slightly higher in a European comparison. Scandinavian countries and the Netherlands have multiple births in the natural range of less than 5%. Nevertheless, in Germany we are pleased about the sharply falling trend towards multiple births with their increased risk of premature birth of over 80%.

In this graphic we show the development of the pregnancy rate, the birth rate and the abortion rate depending on age. The statistics refer exclusively to fresh cycles and combine IVF and ICSI. Pregnancy and birth rates are calculated per embryo transfer.

Until the age of 31, the pregnancy rate remains above 39%. Births, in turn, are over 25% per embryo transfer up to the age of 35. From our point of view, this is very important for advice and the assessment of the respective opportunities.

Miscarriages (abortions) should also be taken into account in the consultation based on age: while they are significantly less than 20% per pregnancy in women up to the age of 35, they rise to 37.1% at the age of 40 and even rise to over 66% in patients aged 45 and over.

For example, a 35-year-old patient has a pregnancy rate of 35.2% and a birth rate of 27.2%.

From the age of 40 onwards, pregnancy and birth rates drop significantly every year. Every year of life has a big influence here. Patients 45 or older had only 21 pregnancies (4.7%) after a total of 455 transfers and only six births (1.3% per transfer) were documented in this age group in all of 2024!

When it comes to advice, it is therefore extremely important that the fertility treatment should take place promptly, especially in the group of patients aged 35 and over, which is where most of our patients are.

Important for advice and assessment of the chances is not only the pregnancy and birth rate per treatment or per embryo transfer, but also the pregnancy rate over several cycles. This is particularly true in the era of single-embryo transfer and the improved results of freezing via vitrification.

For these reasons, we calculated pregnancy rates per transfer cumulatively, regardless of whether it was a second fresh cycle or a thawing (cryotransfer) cycle.

After just two embryo transfers, 53.7% of our patients are pregnant. After three transfers this is more than six out of ten and after four transfers this is already more than two thirds of all fertility patients.

Also included in this consideration are the cycles in which the first embryo transfer did not take place fresh, but after thawing. This, for example, if an embryo transfer in the fresh cycle could not be carried out for medical reasons. At least 28,993 first embryo transfers took place after thawing. The pregnancy rate was even slightly higher than in the fresh cycle (34.9% versus 33.7%).

A cumulative pregnancy rate can be achieved primarily through cryopreservation and subsequent transfers after thawing, without the need for further stimulation and puncture of the eggs.

In Germany, neither cryopreservation nor the subsequent transfer are still part of the standard services paid by statutory health insurance companies. This prevents some from taking advantage of the opportunities of freezing and thawing. On the other hand, cryopreservation is being used more and more often because the chances are at least the same and the effort is much lower.

Dr. med. Ute Czeromin, Mülheim an der Ruhr (leading)Dr. med. Andreas Tandler-Schneider, BerlinProf. Dr. med. Jan-Steffen Krüssel, DüsseldorfDr. med. Sascha Tauchert, Saarbrücken