What was the utilization, effectiveness and safety of assisted reproductive technology (ART) in Latin America during 2020?
Retrospective collection of multinational data on ART performed by 188 institutions in 16 countries.
Overall, 87,732 initiated cycles, resulted in 12,778 deliveries and 21,096 births. The major contributors were Brazil (46.0%), Mexico (16.9%) and Argentina (16.8%). However, the highest utilization (cycles/million inhabitants) were Uruguay with 558, followed by Argentina, 490 and Panama, 425 cycles/M. Globally, women aged ≥40 years increased to 34.0% while women ≤34 dropped to 24.7%. After removing freeze-all cycles, the delivery rate (DR) per oocyte retrieval was 14.8% for ICSI and 15.6% for IVF. Single-embryo transfer (SET) represented 38.3% of all fresh transfers, with DR per transfer of 19.9%; increasing to 32.4% for eSET and 34.2% for blastocyst eSET, compared with blastocyst eDET of 37.9%. However, multiple births increased from 1% in eSET to 30.3% in eDET. Perinatal mortality increased from 7.7‰ in singletons, 24.4‰ in twins, and 64.0‰ in triplets. Frozen embryo transfer (FET) represented 66.6% of all transfers, with a DR/transfer of 29.0%, significantly higher than fresh transfers at all ages. Preimplantation genetic testing (PGT) reported in 8920 cycles significantly improved DR and miscarriage rates at all ages, including oocyte donation. Endometriosis was diagnosed in 28.2% of cases, The DR in 5779 women after removal of peritoneal endometriosis, was significantly better than tubal and endocrine factors.
: Systematic collection and analysis of big data in a south-south cooperation model allow regional growth by implementing evidence-based reproductive decisions.
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Fernando Zegers-Hochschild is emeritus professor at the Faculty of Medicine, University Diego Portales, Chile. Founder and chairman of the Latin American Registry of ART and co-founder and vice chair of ICMART. Research interests include monitoring trends in safety, efficacy and influence of regional diversity in the practice of ART.
Accepted: March 6, 2023
Received in revised form: March 3, 2023
Received: February 14, 2023
Publication stageIn Press Journal Pre-Proof
© 2023 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.