Silke Dyer1, Paversan Archary2, Jacques de Mouzon3, Moise Fiadjoe4, Oladapo Ashiru5. 1. Department of Obstetrics and Gynaecology, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; African Network and Registry for Assisted Reproductive Technology. Electronic address: k.walters@unsw.edu.au. 2. Department of Obstetrics and Gynaecology, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; African Network and Registry for Assisted Reproductive Technology. 3. Institut National de la Santé et de la Recherche Médicale Service de Gynécologie Obstétrique II et de Médecine de la Reproduction, Groupe Hospitalier Cochin-Saint Vincet de Paul, Paris, France. 4. Groupe Interafricain d'Etude, de Recherche et d'Application sur la Fertilité. 5. African Fertility Society.
Abstract
RESEARCH QUESTION: What were utilization, outcomes and practices in assisted reproductive technology (ART) in Africa in 2013? DESIGN: To initiate a data registry in Africa, retrospective summary data were collected in a cross-sectional survey. RESULTS: Forty ART centres from 13 countries collectively reported 25,770 initiated cycles. Regional ART utilization could not be established due to large inter-country variations and insufficient data. The pregnancy rate per aspiration for fresh non-donor IVF and intracytoplasmic sperm injection was 28.0% and 35.8%, with a preponderance of women under 35 years (57.3%). Deliveries were reported for only 56.1% of pregnancies; the remainder were lost to follow-up. A mean of 2.41 embryos were transferred. The multiple delivery rate was 26.7% (25.5% twins and 1.2% triplets). Most twins (52.7%) and triplets (73.7%) were born pre-term. Oocyte donation represented 7% of all fresh and frozen transfers. CONCLUSION: This marks the beginning of an ART registry in Africa, Since ART utilization could not be established, the degree of access to ART remains speculative. Pregnancy rates were favourable but underpinned by a preponderance of young women and the transfer of multiple embryos. Efforts are needed to explore treatment barriers, improve pregnancy follow-up and reduce the high rate of multiples. This inaugural report from the African Network and Registry for Assisted Reproductive Technology (ANARA) indicates a willingness and ability of ART centres to voluntarily report and monitor utilization and outcomes of ART, which reflects a rising standard of ART in Africa. It is anticipated that more centres and countries will join ANARA to continue this trend.
RESEARCH QUESTION: What were utilization, outcomes and practices in assisted reproductive technology (ART) in Africa in 2013? DESIGN: To initiate a data registry in Africa, retrospective summary data were collected in a cross-sectional survey. RESULTS: Forty ART centres from 13 countries collectively reported 25,770 initiated cycles. Regional ART utilization could not be established due to large inter-country variations and insufficient data. The pregnancy rate per aspiration for fresh non-donorIVF and intracytoplasmic sperm injection was 28.0% and 35.8%, with a preponderance of women under 35 years (57.3%). Deliveries were reported for only 56.1% of pregnancies; the remainder were lost to follow-up. A mean of 2.41 embryos were transferred. The multiple delivery rate was 26.7% (25.5% twins and 1.2% triplets). Most twins (52.7%) and triplets (73.7%) were born pre-term. Oocyte donation represented 7% of all fresh and frozen transfers. CONCLUSION: This marks the beginning of an ART registry in Africa, Since ART utilization could not be established, the degree of access to ART remains speculative. Pregnancy rates were favourable but underpinned by a preponderance of young women and the transfer of multiple embryos. Efforts are needed to explore treatment barriers, improve pregnancy follow-up and reduce the high rate of multiples. This inaugural report from the African Network and Registry for Assisted Reproductive Technology (ANARA) indicates a willingness and ability of ART centres to voluntarily report and monitor utilization and outcomes of ART, which reflects a rising standard of ART in Africa. It is anticipated that more centres and countries will join ANARA to continue this trend.
Authors: Tendai M Chiware; Nathalie Vermeulen; Karel Blondeel; Roy Farquharson; James Kiarie; Kersti Lundin; Thabo Christopher Matsaseng; Willem Ombelet; Igor Toskin Journal: Hum Reprod Update Date: 2021-02-19 Impact factor: 15.610