Fernando Zegers-Hochschild1, Javier A Crosby2, Carolina Musri2, Maria do Carmo Borges de Souza3, A Gustavo Martinez4, Adelino Amaral Silva5, José María Mojarra6, Diego Masoli2, Natalia Posada7. 1. Unit of Reproductive Medicine, Clínica Las Condes, Lo Fontecilla 441, Santiago, Chile; Program of Ethics and Public Policies in Human Reproduction, Universidad Diego Portales, Ejercito 260, Santiago, Chile. Electronic address: fzegers@clinicalascondes.cl. 2. Unit of Reproductive Medicine, Clínica Las Condes, Lo Fontecilla 441, Santiago, Chile. 3. Fertipraxis, Av. das Américas, 4.666 Sls 312/313, Barra da Tijuca Rio de Janeiro, Brasil. 4. Fertilis, Av. Fondo de la Legua 277 (B1609JEC), San Isidro Pcia. De Buenos Aires, Argentina. 5. Genesis-Centro de Assistência em Reprodução Humana, SHLS cj L, Aales Tes L331, Brasilia DF 70390-907, Brasil. 6. Hospital CIMA Hermosillo, Paseo Río San Miguel 35, Col. Proyecto Rio Sonora C.P, Hermosillo Sonora 83280, México. 7. INSER, Calle 12 No. 39-60, Sector El Poblado Medellín, Colombia.
Abstract
RESEARCH QUESTION: What was the utilization, effectiveness and safety of assisted reproductive technologies (ART) carried out in Latin America during 2017. DESIGN: Retrospective collection of multinational data on ART carried out in 188 institutions from 15 Latin American countries. RESULTS: In this study, 93,600 initiated cycles, 16,976 deliveries and 20,404 births reported. Utilization of ART was 221 cycles per million inhabitants (15 to 535). Women aged 40 years and above represented 30.5% of fresh IVF and intracytoplasmic sperm injection (ICSI); however, after removing freeze-all cycles, delivery rate per oocyte retrieval was 19.9% for ICSI and 20.2% for IVF. Overall, single embryo transfer (SET) represented 26.9% of fresh transfers, with 18.2% delivery rate per transfer, increasing to 32.3% in elective SET. Delivery rate in double embryo transfers (DET) was 28.3% increasing to 37.3% with elective DET. This 5% increment in births in elective DET over elective SET resulted in a tenfold increase in twin births, gestational periods almost 3 weeks' shorter and a threefold increase in perinatal mortality. Delivery rate in frozen-thawed SET reached 25.5% increasing to 30.8% with DET, most being blastocyst transfers. Of all births, 66.9% were singletons, 31.4% twins and 1.6% triplets and higher. Overall, preterm deliveries reached 9.5% in singletons, 64.3% in twins and 97.9% in triplets; perinatal mortality was 9.4‰ in singletons, 25.3‰ in twins and 63.3‰ in high-order multiples. CONCLUSIONS: The number of initiated cycles has slowly increased. Frozen embryo transfers, blastocyst transfers and SET are also increasing. Our data show that, especially in young women and oocyte recipients, when there is more than one blastocyst for transfer, elective SET should be the rule.
RESEARCH QUESTION: What was the utilization, effectiveness and safety of assisted reproductive technologies (ART) carried out in Latin America during 2017. DESIGN: Retrospective collection of multinational data on ART carried out in 188 institutions from 15 Latin American countries. RESULTS: In this study, 93,600 initiated cycles, 16,976 deliveries and 20,404 births reported. Utilization of ART was 221 cycles per million inhabitants (15 to 535). Women aged 40 years and above represented 30.5% of fresh IVF and intracytoplasmic sperm injection (ICSI); however, after removing freeze-all cycles, delivery rate per oocyte retrieval was 19.9% for ICSI and 20.2% for IVF. Overall, single embryo transfer (SET) represented 26.9% of fresh transfers, with 18.2% delivery rate per transfer, increasing to 32.3% in elective SET. Delivery rate in double embryo transfers (DET) was 28.3% increasing to 37.3% with elective DET. This 5% increment in births in elective DET over elective SET resulted in a tenfold increase in twin births, gestational periods almost 3 weeks' shorter and a threefold increase in perinatal mortality. Delivery rate in frozen-thawed SET reached 25.5% increasing to 30.8% with DET, most being blastocyst transfers. Of all births, 66.9% were singletons, 31.4% twins and 1.6% triplets and higher. Overall, preterm deliveries reached 9.5% in singletons, 64.3% in twins and 97.9% in triplets; perinatal mortality was 9.4‰ in singletons, 25.3‰ in twins and 63.3‰ in high-order multiples. CONCLUSIONS: The number of initiated cycles has slowly increased. Frozen embryo transfers, blastocyst transfers and SET are also increasing. Our data show that, especially in young women and oocyte recipients, when there is more than one blastocyst for transfer, elective SET should be the rule.
Authors: Ch De Geyter; C Wyns; C Calhaz-Jorge; J de Mouzon; A P Ferraretti; M Kupka; A Nyboe Andersen; K G Nygren; V Goossens Journal: Hum Reprod Date: 2020-12-01 Impact factor: 6.918
Authors: Fernando Zegers-Hochschild; Javier A Crosby; Carolina Musri; Maria do Carmo Borges de Souza; A Gustavo Martínez; Adelino Amaral Silva; José María Mojarra; Diego Masoli; Natalia Posada Journal: JBRA Assist Reprod Date: 2021-10-04