Assisted reproductive techniques in Latin America: The Latin American Registry, 2017

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.

Celebrating 30 years of ART in Latin America; and the 2018 report

“…As described previously ( Zegers-Hochschild et al, 2020a ; b ) , a detailed description of the sequence of events that take place from the start of an ART cycle until embryos are transferred is described for 2018 in Figure 12 . In cases of IVF/ICSI, there were only 19,706 embryo transfers out of 47,635 initiated cycles.…”

“…Methods of data collection have experienced minimal changes since 2012 when the cycle-based registry was fully implemented and can be found in Zegers-Hochschild et al (2020a ; b) . In previous years, summary data were available, which makes it difficult to examine trends on very sophisticated variables such as outcome of blastocyst transfers or elective transfers, which have only been available since 2012.…”

Primer niño logrado por fertilización in vitro en la Amazonía del Perú

“…América Latina siempre ha presentado un menor acceso a los TRA en comparación a los países desarrollados (11) . En el año 2017, América Latina alcanzó 221 ciclos iniciados por millón de habitantes, considerando los 12 países que reportan al Registro Latinoamericano de Reproducción Asistida (RLA) y cuyos datos son confiables; además, en el Perú se realizaron 205 ciclos por millón de habitantes (12) . Estas cifras se encuentran muy por debajo del umbral de 1 500 ciclos anuales por millón de habitantes propuesto por el Grupo ESHRE Capri, con el fin de satisfacer las necesidades de una población (13) .…”

Cross-border reproductive healthcare

“…Warning that the registry does not cover all the clinics in the region, they reported a total of 2415 2 initiated cycles, carried out in 21 centers, located in eight countries: Argentina, Brazil, Colombia, Chile, Ecuador, Mexico, Panama, and Venezuela (Zegers-Hochschild and Prado Aravena 1990). By 1996, the registry reported 10,359 cycles initiated in 76 centers in 13 countries (Zegers-Hochschild 1996). Although the registry has never been able to include the totality of the clinics operating in each country, their numbers suggest the minimum threshold, one that has been increasing since 1990 (see also Inhorn and Patrizio 2015).…”

“…In 2016, 178 centers located in 15 countries initiated 85,474 cycles, one year later, in 2017, 188 centers located in the same 15 countries carried out 93,600 cycles(Zegers-Hochschild et al 2020). As a comparative note: ESHRE reported 686,271 cycles performed in 1169 centers located throughout 38 countries.…”