Assisted reproductive technology in Latin America: the Latin American Registry, 2017

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 parts per thousand in singletons, 25.3 parts per thousand in twins and 63.3 parts per thousand 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.