Abstract
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‰ in singletons, 17.2‰ for twins and 62.9‰ 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.
Key words
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REFERENCES
- Access to ART: Concepts indicators, impact.Hum. Reprod. 2019; 34: i65-i66
- Cumulative live birth rate: time for a consensus?.Human Reproduction. 2015; 30: 2703-2707
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Biography
Fernando Zegers-Hochschild is the founder and chairman of the Latin American Registry of ART and co-founder of the International Committee for Monitoring ART. His main research interests include monitoring trends in the safety, efficacy and influence of cultural diversity on the practice of ART, as well as its bioethical challenges.
Key message
This report includes 80% of the ART cycles carried out in Latin America in 2019. Utilization is increasing and women's ages continue to rise. Frozen embryo transfers are preferred over fresh transfers, and blastocyst over cleaving-stage embryos. Elective single-blastocyst transfer should be the preferred treatment for young women and oocyte recipients.
Article info
Publication history
Published online: March 11, 2022
Accepted:
February 27,
2022
Received in revised form:
February 17,
2022
Received:
January 24,
2022
Declaration: The authors report no financial or commercial conflicts of interest.Identification
Copyright
© 2022 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
