Fernando Zegers-Hochschild1,2,3, Javier A Crosby1,3, Carolina Musri1,3, Maria do Carmo B de Souza3,4, A Gustavo Martinez3,5, Adelino Amaral Silva3,6, José María Mojarra3,7, Diego Masoli1,3, Natalia Posada3,8. 1. Unit of Reproductive Medicine, Clínica Las Condes, Santiago, Chile. 2. Program of Ethics and Public Policies in Human Reproduction, University Diego Portales, Santiago, Chile. 3. Latin American Network of Assisted Reproduction (REDLARA), Montevideo, Uruguay. 4. Fertipraxis, Rio de Janeiro, RJ, Brazil. 5. Fertilis Medicina Reproductiva, San Isidro, Buenos Aires, Argentina. 6. Genesis Centro de Assistência em Reprodução Humana Ltda, Brasília, DF, Brazil. 7. URA, Unidad de Reproducción Asistida de Hospital CIMA Hermosillo, Hermosillo, Sonora, Mexico. 8. INSER, Medellín, Colombia.
Abstract
RESEARCH QUESTION: What was the utilization, effectiveness and safety of assisted reproductive techniques performed in Latin America during 2017. DESIGN: Retrospective collection of multinational data on ART performed in 188 institutions from 15 Latin American countries. RESULTS: We are reporting 93,600 initiated cycles, 16,976 deliveries and the birth of 20,404 babies. ART utilization was 221 cycles/million inhabitants (15 to 535). Despite women aged ≥40 represented 30.5% of fresh IVF/ICSI, 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 eDET over eSET resulted in10-fold increase in twin births, almost 3 weeks' shorter gestations and 3-fold increase in perinatal mortality. Delivery rate in frozen/thawed SET, reached 25.5% increasing to 30.8% with DET; the majority being blastocysts transfers. Of all births, 67% 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; and perinatal mortality was 9.4‰ in singletons, 25.3‰ in twins, and 63.3‰ in high-order multiples. CONCLUSIONS: The number of initiated cycles slowly increases. Frozen embryo transfers, blastocyst transfers and SET are also increasing. Our data shows 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 techniques performed in Latin America during 2017. DESIGN: Retrospective collection of multinational data on ART performed in 188 institutions from 15 Latin American countries. RESULTS: We are reporting 93,600 initiated cycles, 16,976 deliveries and the birth of 20,404 babies. ART utilization was 221 cycles/million inhabitants (15 to 535). Despite women aged ≥40 represented 30.5% of fresh IVF/ICSI, 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 eDET over eSET resulted in10-fold increase in twin births, almost 3 weeks' shorter gestations and 3-fold increase in perinatal mortality. Delivery rate in frozen/thawed SET, reached 25.5% increasing to 30.8% with DET; the majority being blastocysts transfers. Of all births, 67% 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; and perinatal mortality was 9.4‰ in singletons, 25.3‰ in twins, and 63.3‰ in high-order multiples. CONCLUSIONS: The number of initiated cycles slowly increases. Frozen embryo transfers, blastocyst transfers and SET are also increasing. Our data shows that especially in young women and oocyte recipients, when there is more than one blastocyst for transfer, elective SET should be the rule.
Entities:
Keywords:
ART utilization; Assisted reproductive technology; Latin American Registry; perinatal outcome; success rates
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