CARTRPLUS Cycle (ART)

Data Definition: Health card number of patient. If OHIP number, use 10-digit number and exclude version code.

Data Definition: Type of health card provided by patient. RAMQ is entered for Quebec patients seeking treatment in Ontario.

Data Definition: Name patient who intends to raise the child. Name as it appears on official Health Card. For donor oocyte/embryo cycles, the oocyte/embryo recipient is the patient. For same sex male couples, one of the male partners is the patient. A single male can be a patient/intended parent. For same-sex females sharing eggs, the embryo recipient is the patient and the egg provider is the egg donor/provider.

Data Definition: Name of patient who intends to raise the child. Name as it appears on official Health Card. For donor oocyte/embryo cycles, the oocyte/embryo recipient is the patient. For same sex male couples, one of the male partners is the patient. A single male can be a patient. For same-sex females sharing eggs, the recipient is the patient and the egg provider is the egg donor/provider.

Data Definition: Name of patient who intends to raise the child. Name as it appears on official Health Card. For donor oocyte/embryo cycles, the oocyte/embryo recipient is the patient. For same sex male couples, one of the male partners is the patient. A single male can be a patient. For same-sex females sharing eggs, the recipient is the patient and the egg provider is the egg donor/provider.

Data Definition: Unique code assigned to clinic.

Data Definition: Gender of the patient. As self-identified at the time of cycle start. Some patients do not identify with either gender (nonbinary/gender diverse).

Data Definition: Date of birth of patient

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Data Definition: You may press "Ctrl+F" to search for a value or keyword

Data Definition: You may press "Ctrl+F" to search for a value or keyword

Data Definition: The patient's unique file number assigned by care provider (e.g. chart number, client number). For non-Ontario clinics, no patient identifying information, or parts thereof, can be used (i.e., no patient name, initials, or complete health card number)

Data Definition: Generic text field to document notes related to the cycle(s) for this selected patient. Field not available for non-Ontario clinics.

Data Definition: Primary cycle: Unique code used by clinic to identify a single oocyte collection (IVF, IVM or Oocyte banking cycle). Secondary cycle: Unique code used by clinic to identify an FET cycle or Frozen oocyte IVF cycle. If no cycle ID is created for a secondary cycle (Frozen oocyte IVF or FET), clinic can choose to use primary cycle ID with - 1,2,3,etc.

Data Definition: Date of first dose of FSH in stimulated cycle or day 1 of cycle (last menstrual period - LMP) for cycle with no stimulation. For FET cycle or cycle using frozen oocytes, it can be LMP or start of monitoring.

Data Definition: Generic text field to document notes related to stimulation of oocyte provider. For Non-Ontario clinics, no patient identifying information, or parts thereof, can be used.

Data Definition: Unique code used by clinic to track a full cycle from oocyte collection to use of all embryos generated from that oocyte collection, i.e. fresh transfer and FETs etc… For frozen embryos or frozen oocytes received from another clinic, the receiving clinic assigns a number to identify that cohort of embryos or oocytes and uses that number to track all future uses of those embryos or oocytes, i.e. could include multiple FETs (frozen embryos) or an IVF cycle with subsequent FETS (frozen oocytes)

Data Definition: Age of patient (female, male or nonbinary/gender diverse) at start of cycle automatically calculated using cycle start date and patient date of birth.

Data Definition: Number of prior pregnancies for patient with same or different partner, with or without ART including ectopic pregnancy.

Data Definition: Number of prior births for patient with same or different partner, with or without ART, including stillbirth. Birth of more than one baby (multiple birth) is defined as one birth.

Data Definition: Number of prior initiated cycles (starts) for this patient, same clinic or other clinics. Start defined as FSH received in a stimulated cycle or after monitoring started in a natural cycle.

Data Definition: Number of prior ET procedures (fresh or frozen) that patient had with their own oocytes. ET using a surrogate is excluded.

Data Definition: Number of prior ET procedures (fresh or frozen) that patient had with donor oocytes ET using a surrogate is excluded

Data Definition: Infertility diagnosis or other reasons for treatment cycle Select all applicable.

Data Definition: Detailed male factor(s) related to reasons for treatment cycle. Select all applicable

Data Definition: Primary cycle: A cycle that includes an oocyte collection that results in IVF, IVM, or oocyte banking. Secondary cycle: A cycle that does not include an oocyte collection but instead uses thawed oocytes or thawed embryos

Data Definition: Antral Follicle Count (AFC) of oocyte provider closest to cycle start date.

Data Definition: Anti-Mullerian Hormone level of oocyte provider Indicate applicable value for this lab test either ng/ml or pmol/L closest to cycle start date.

Data Definition: AMH level of oocyte provider Unit of Measure. Radio button to select unit (ng/mL or pmol/L)

Data Definition: Indicates if a cycle was stopped before stimulation started in IVF/IVM/oocyte banking cycles or before oocytes or embryos thawed in Frozen oocyte IVF/FET cycles. Cycles with Cycle Stopped = 'Y' will be excluded from reporting in CARTR Plus.

Data Definition: Ovarian stimulation protocol received by oocyte provider. In a donor oocyte cycle, the protocol is the one received by the donor and not recipient. Select one only.

Data Definition: Description of other type of stimulation protocol used in this cycle

Data Definition: Medication received for controlled ovarian stimulation (COS) In a donor oocyte cycle, the medication is the one received by the donor and not recipient. Note: Agonist or antagonist drugs are included under “Type of Stimulation Protocol”. Select all applicable.

Data Definition: Description of other medications used for COS in this cycle

Data Definition: Medication received by oocyte provider to modify the effect of the gonadotropins. Select all applicable

Data Definition: Description of other adjuvant medications used in this cycle

Data Definition: Medication received by oocyte provider to complete oocyte maturation before collection.

Data Definition: Description of other trigger medications used in this cycle

Data Definition: Number of days of stimulation from 1st day of FSH to trigger day or day of cancellation.

Data Definition: Total IU of FSH received in cycle – does not include dose of LH.

Data Definition: Total dose of FSH Unit of Measure

Data Definition: Total mcg dose of Rekovelle FSH received in cycle – does not include dose of LH.

Data Definition: Number of small, growing follicles (<15mm) at trigger or cancellation.

Data Definition: Number of large, growing follicles (≥15 mm) at trigger or cancellation.

Data Definition: Serum Estradiol value within one day of trigger or cancellation

Data Definition: Serum Progesterone value within one day of trigger or cancellation

Data Definition: Thickness of endometrium closest to day of trigger or cancellation. Does not apply when donor oocytes are used or if a freeze-all cycle is intended, the recipient endometrial thickness is entered in the “transfer” tab.

Data Definition: Cycle in which ovarian stimulation or monitoring has been carried out with the intention to treat, but did not proceed to oocyte collection

Data Definition: Reason for cancellation of oocyte collection Select all applicable

Data Definition: Description of other reasons for cancellation of oocyte collection

Data Definition: Date of oocyte collection

Data Definition: Date of oocyte thawing/warming

Data Definition: Unique code originally assigned to the oocyte cohort at freezing. For frozen oocytes received from another clinic, code given by the receiving clinic to that cohort of oocytes.

Data Definition: Unique code originally assigned to the oocyte cohort at freezing if two oocyte cohorts are used at the same time. For frozen oocytes received from another clinic, code given by the receiving clinic to that cohort of oocytes.

Data Definition: Origin of the oocytes to be used. Choose partner oocytes when partner provides oocytes for partner to be the embryo recipient

Data Definition: Unique code to identify the oocyte donor

Data Definition: Type of donation: Health Canada Regular Donation Process applies to all donor gametes used for the purpose of ART. This is also known as anonymous donation. Health Canada Directed Donation Process applies in cases where the donor and the recipient know each other. For partner oocyte provider, choose partner oocyte (reciprocal). If oocyte provider intends to keep some oocytes for own use, choose directed or anonymous (Regular) oocyte sharing, whichever applies. Select all applicable

Data Definition: Patient age at oocyte collection when using own oocytes or donor age at oocyte collection when using donor oocytes. Range 10-65 There is the ability to set the age to unknown if not available for donor oocytes but this will limit the cycle’s inclusion in analysis based on age of oocyte provider.

Data Definition: Number of cumulus-oocyte complexes (COCs) collected and/or number of oocytes thawed

Data Definition: Number of oocytes frozen or vitrified in an oocyte banking cycle or an IVF cycle e.g. no sperm were available

Data Definition: Unique code to identify that cohort of frozen oocytes.

Data Definition: Date of oocyte cryopreservation

Data Definition: Type of method used to cryopreserve the oocytes

Data Definition: Origin of male gametes used to create embryos. Select all applicable.

Data Definition: Unique code to identify the sperm donor

Data Definition: Type of donation

Data Definition: Age of sperm provider at sperm collection. Do not enter if more than one sperm provider is used in this cycle or if sperm from more than one collection date is used in this cycle (e.g. fresh and frozen sperm used)

Data Definition: Source of collected sperm (for partner if both partner and donor sperm used). Select one only

Data Definition: Volume of fresh (pre-wash) semen sample - only applicable for fresh partner semen Normal semen volume, as determined by the World Health Organization (WHO), is 1.3-1.5 ml. A volume of less than 1.3 ml will auto populate male factor in the reasons for treatment cycle (ART0150) data element

Data Definition: Sperm concentration in fresh (pre-wash) semen sample – only applicable for fresh partner semen Normal sperm count, as determined by the World Health Organization (WHO), is 15-259 million per ml. A count of less than 15 million per mL will auto populate male factor in the reasons for treatment cycle (ART0150) data element.

Data Definition: Too few sperm to make an accurate count.

Data Definition: Percentage of motile sperm in fresh (pre-wash) semen sample – only applicable for fresh partner semen Normal sperm motility, as determined by the World Health Organization (WHO), is 40-43%. A motility of less than 40% will auto populate male factor in the reasons for treatment cycle (ART0150) data element

Data Definition: Method(s) used to inseminate the oocytes Select all applicable Note: If insemination method was IMSI (Intracytoplasmic Morphologically Selected Sperm Injection), select ICSI.

Data Definition: Number of COCs inseminated by conventional IVF and/or number of oocytes injected by ICSI

Data Definition: Number of COCs collected in a fresh cycle or number of thawed/warmed oocytes that were not used in this cycle

Data Definition: Reasons for not using some of the COCs or thawed/warmed oocytes. Select all applicable.

Data Definition: Number of MII oocytes injected and/or number of MII oocytes on day 1 after conventional IVF (not possible to have an accurate value on day 0 in conventional IVF)

Data Definition: Number of zygotes with normal fertilization, i.e. 2PN

Data Definition: Number of embryos utilizable by the end of the culture period, irrespective of whether surplus embryos were cryopreserved (frozen) or not.

Data Definition: Number of embryos frozen or vitrified in this cycle

Data Definition: Embryo stage at time of cryopreservation. Select all applicable.

Data Definition: Method used to cryopreserve the embryos

Data Definition: Unique code to identify freeze of first batch of embryos from this cycle

Data Definition: Date associated with freeze of first batch of embryos from this cycle

Data Definition: Unique code to identify freeze of second batch of embryos from this cycle

Data Definition: Date associated with freeze of second batch of embryos from this cycle

Data Definition: Unique code to identify freeze of third batch of embryos from this cycle

Data Definition: Date associated with freeze of third batch of embryos from this cycle

Data Definition: Unique code to identify freeze of fourth batch of embryos from this cycle

Data Definition: Date associated with freeze of fourth batch of embryos from this cycle

Data Definition: Date of embryo thawing/warming with the intent of transferring them in an FET cycle

Data Definition: Unique code originally assigned to the embryo cohort at freezing. For frozen embryos received from another clinic, code given by receiving clinic for that cohort of embryos.

Data Definition: Unique code originally assigned to the second embryo cohort at freezing if more than one cohort used. For frozen embryos received from another clinic, code given by receiving clinic for that cohort of embryos

Data Definition: Unique code originally assigned to the third embryo cohort at freezing if more than two cohorts used. For frozen embryos received from another clinic, code given by receiving clinic for that cohort of embryos

Data Definition: Unique code originally assigned to the fourth embryo cohort at freezing if more than three cohorts used. For frozen embryos received from another clinic, code given by receiving clinic for that cohort of embryos

Data Definition: Indicate whether or not embryos are donated

Data Definition: Number of embryos thawed/warmed in this FET cycle

Data Definition: Type of embryos thawed/warmed in this FET cycle. Select all applicable.

Data Definition: Method used to cryopreserve the thawed/warmed embryos.

Data Definition: Number of thawed/warmed embryos utilizable for transfer or refreezing by end of culture post thaw/warm.

Data Definition: Transfer of embryos into uterine cavity of patient or surrogate in a fresh or frozen cycle. Select NO if transfer was attempted but was not successful.

Data Definition: Protocol used to prepare the uterine lining before transfer

Data Definition: Thickness of endometrium within a few days

Data Definition: If embryo transfer is not done, indicate the reason. Select one only

Data Definition: Date of embryo transfer. If embryos are transferred on more than one day, enter the first transfer date.

Data Definition: Stage of fresh embryos at transfer

Data Definition: Method used to thin or perforate the zona before transfer, for all or some embryos.

Data Definition: Number of embryos transferred fresh and/or thawed/warmed, including thawed embryos added to a fresh transfer. Include all embryos transferred even if on different days

Data Definition: Origin of embryos for this transfer. Select all applicable

Data Definition: A person who carries a pregnancy with an agreement that they will give the offspring to the intended parent(s). Gametes can originate from the intended parent(s) and/or a third party (parties)

Data Definition: Gestational Carrier unique identifier at the clinic level

Data Definition: Height of patient at ET or FET, or height of gestational carrier receiving the embryo This field is automatically filled in with the height of the oocyte provider. If donor oocytes or a gestational carrier is used, this field should be filled in manually.

Data Definition: Weight of patient at ET or FET, or weight of gestational carrier receiving the embryo This field is automatically filled in with the weight of the oocyte provider If donor oocytes or a gestational carrier is used, this field should be filled in manually.

Data Definition: Body Mass Index (in kg/m2) of patient at ET or FET, or BMI of gestational carrier receiving the embryo. If height and weight are entered, BMI will be calculated automatically when the SAVE or PROCEED button is clicked. BMI can be entered directly.

Data Definition: Complications experienced by patient/ oocyte donor during this cycle. Select all applicable. Enter 'none' for complications not on this list

Data Definition: Did the patient require hospitalization as a result of the adverse events experienced during this treatment cycle?

Data Definition: Outcome of treatment cycle To be completed for ALL treatment cycles (except Oocyte Banking and Simulated Primary Cycles), including cycles that were cancelled after start of stimulation and prior to egg collection, had no insemination, no fertilization, or no embryo transfer Patients lost in follow-up are included as unknown

Data Definition: Type of pregnancy achieved. Select one only

Data Definition: Number of gestational sacs (includes ectopic and heterotopic) by ultrasonographic visualization at ≈6-8 weeks

Data Definition: Number of fetal hearts (includes ectopic or heterotopic) by ultrasonographic visualization at ≈6-8 weeks. If a later ultrasound showed more fetal hearts, enter the later results.

Data Definition: Status of chorion when more than one fetal heart observed

Data Definition: Elective fetal reduction performed

Data Definition: Outcome from the clinical pregnancy.

Data Definition: Newborn day/month/year of birth.

Data Definition: Date of pregnancy loss

Data Definition: Number of babies born at 20 weeks + one day or more, including live born and still born.

Data Definition: Select all applicable health conditions (pre-existing, diagnosed or active during pregnancy).

Data Definition: Select all complications experienced during this pregnancy, except for hypertension or diabetes. These conditions are captured in separate data elements. Enter 'None' for complications not on this list.

Data Definition: Select diabetic status and type for this pregnancy, as documented on the medical record or patient history.

Data Definition: Identification of all hypertensive conditions the pregnant person experienced during this pregnancy.

Data Definition: Indicates the type of labour as active labour (dilation greater than or equal to 4 cm) achieved without intervention(s) such as cervical ripening, amniotomy, oxytocin, misoprostol; induced in latent phase (dilation up to and including 3 cm); induced prior to contractions (cold induction); or, if there was no labour or latent phase only

Data Definition: Interventions used to improve the quality and effectiveness when labour start is spontaneous.

Data Definition: All indications for induction of labour. Induction refers to the initiation of labour.

Data Definition: Indicate interventions used to ripen cervix for labour prior to induction. Select all that apply.

Data Definition: Indicates all methods of induction used to initiate and establish effective labour.

Data Definition: Indicate all medical and non-medical indications for cesarean section.

Data Definition: Indicate how the baby was born. When entering data in the event of multiple births, enter the highest intervention.

Data Definition: Indicate all intrapartum complications during this labour and birth

Data Definition: Maternal disposition

Data Definition: Outcome from the clinical pregnancy

Data Definition: Sex of baby

Data Definition: Birth weight in grams

Data Definition: All structural, functional, and genetic anomalies diagnosed in aborted fetuses, at birth or in the neonatal period.

Data Definition: Death of a live born baby within 28 days of birth.

Data Definition: # of weeks and days of gestation.

Data Definition: APGAR Score at 1 minute.

Data Definition: Indicate APGAR score at 5 minutes of age

Data Definition: APGAR Score at 10 minutes.

Data Definition: Indicate all newborn complications and/or conditions.

Data Definition: Indicate newborn’s transfer to the NICU

Data Definition: Estimated date of birth. This field is automatically calculated as “transfer date” +38 weeks.

Data Definition: Text field to document the clinic of origin of the oocytes or embryos

Data Definition: A primary cycle that originally occurred either in another clinic and/or prior to January 1, 2013. For donated oocytes or those purchased from an egg bank, a simulated cycle is created to establish a primary (oocyte collection) cycle. *If the date of oocyte collection and/or age of oocyte provider at time of collection are not available, they can be set to unknown but this will limit the cycle’s inclusion in analysis based on age of oocyte provider.

Data Definition: Height of oocyte provider. Must be reported in cm. Must be between 90cm and 240cm

Data Definition: Weight of oocyte provider. Must be reported in kg. Must be between 25kg and 227kg

Data Definition: Body Mass index (in kg/m²) of oocyte provider. If height (cm) and weight (kg) are entered, system will calculate automatically.

Data Definition: Indicates the site where cells were removed during PGT testing

Data Definition: Number of times transferred embryo has been thawed and refrozen (does not include egg freezes). If more than one embryo is transferred, indicate the embryo that has been thawed and refrozen the highest number of times.

Data Definition: Provides information of embryo testing (if done)

Data Definition: Indicates whether the embryo being transferred has had pre-implantation genetic testing done

Data Definition: Indicates whether this embryo has been created by which insemination method. Note: If insemination method was IMSI (Intracytoplasmic Morphologically Selected Sperm Injection), select ICSI.

Data Definition: Indicates whether transfer date has been adjusted due to ERA biopsy result

Data Definition: Reason for embryo cryopreservation

Data Definition: Unique code/name of sperm bank used to obtain donor sperm

Data Definition: Distinct name of the commercial oocyte bank from which the oocytes are sourced. In situations where the oocytes originate from a donor patient within the same clinic, the chart number of the donor patient serves as a unique identifier. Alternatively, the unique identifier can be the name of the primary establishment lab or processor responsible for handling and processing the oocytes.

Data Definition: Total dose of LH in IU

Data Definition: Indicates whether or not there is provincial funding for this cycle.

Data Definition: Indicates type of funding or support for this cycle.

Data Definition: Indicates other type of funding or support for this cycle.

Data Definition: Indicates whether an endometrial receptivity test was performed.

Data Definition: Description of other medications administered prior to COS in this cycle

Data Definition: Medications administered prior to Controlled Ovarian Stimulation (COS)

Data Definition: Planned PGT-A for this cohort of embryos from this cycle.

Data Definition: Ovveride flag used by BORN to remove consent from patient to the clinic

Data Definition: Indicates whether the patient has given permission for their fertility treatment center to retrieve and utilize their BORN pregnancy and birth outcome data.

Data Definition: Fetal ID of a multiple pregnancy

Data Definition: You can search for patients by Chart #, other Health Card #, or other identifiers.

Data Definition: You can search for patients by Chart #, other Health Card #, or Cycle ID #.

Data Definition: You can search for patients by Chart # or Cycle ID #.

Data Definition: You can search for patients by OHIP number.