4.6 Article

Assisted reproductive technologies in Latin America: the Latin American Registry, 2019

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REPRODUCTIVE BIOMEDICINE ONLINE
卷 45, 期 2, 页码 235-245

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ELSEVIER SCI LTD
DOI: 10.1016/j.rbmo.2022.02.026

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ART utilization; Assisted reproductive technology; Efficacy; Latin American Registry; Perinatal outcome

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This study examined the utilization, effectiveness, and safety of assisted reproductive technology (ART) in Latin America in 2019. The results showed an increase in ART utilization and a shift towards frozen-thawed embryo transfers. Selective single-embryo transfer (SET) was found to be important in reducing multiple births.
Research question What was the utilization, effectiveness and safety of assisted reproductive technology (ART) in Latin America during 2019? Design This was a retrospective collection of multinational data on ART performed at 196 institutions from 15 countries. Results A total of 106,918 initiated cycles, 18,133 deliveries and 21,096 births were reported. ART utilization was 24-558 cycles per million inhabitants. Women aged >= 40 years represented 32.9% of fresh IVF and intracytoplasmic sperm injection (ICSI) cycles. After removing freeze-all cycles, the delivery rate per oocyte retrieval was 17.3% for ICSI and 19.5% for IVF. Overall, single-embryo transfer (SET) represented 36.2% of fresh transfers, with a 19.5% delivery rate per transfer, increasing to 30.7% for elective SET and 32.7% for blastocyst elective SET (eSET). The delivery rate for double-embryo transfers (DET) was 27.8%, increasing to 37.1% after elective DET. This 6.4% increment in deliveries between eSET and elective DET resulted in a 12-fold increase in twin births. Furthermore, overall perinatal mortality was more than two-fold higher for twin compared with singleton deliveries. The delivery rate for frozen-thawed SET reached 28.1%, most being blastocyst transfers. Of all births, 72.3% were singletons, 26.4% twins and 1.3% triplets and higher multiples. Preterm deliveries reached 14.3% for singletons and 58.1% for twins. Perinatal mortality was 7.4 parts per thousand in singletons, 17.2 parts per thousand for twins and 62.9 parts per thousand for triplets or higher. Conclusions The number of initiated cycles has slowly increased in countries with laws or regulations facilitating access. FET cycles predominate and blastocyst SET are also increasing. The data show that, especially in young women and oocyte recipients, when there is more than one blastocyst for transfer, eSET should be the rule.

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