Zegers-Hochschild Fernando, Schwarze Juan Enrique, Crosby Javier, Musri Carolina, Urbina Maria Teresa
Unit of Reproductive Medicine Clínica Las Condes, Lo Fontecilla 441, Santiago, Chile; Program of Ethics and Public Policies in Human Reproduction, University Diego Portales, Ejercito 260, Santiago, Chile; Latin American Network of Assisted Reproduction (REDLARA), Plaza Independencia 811, Montevideo, Uruguay.
Latin American Network of Assisted Reproduction (REDLARA), Plaza Independencia 811, Montevideo, Uruguay; Unit of Reproductive Medicine Clínica Monteblanco, Camino Farellones 18780 Santiago, Chile.
Reprod Biomed Online. 2017 Sep;35(3):287-295. doi: 10.1016/j.rbmo.2017.05.021. Epub 2017 Jun 21.
Multinational data on assisted reproduction techniques (IVF and intractytoplasmic sperm injection [ICSI], frozen embryo transfer, oocyte donation, preimplantation genetic diagnosis and fertility preservation) were collected from 159 institutions in 15 Latin American countries. A total of 41.34% of IVF-ICSI cycles were conducted in women aged 35-39 years and 23.35% in women aged 40 years and older. After removing freeze-all cases, delivery rate per oocyte retrieval was 25.05% for ICSI and 27.41% for IVF. Multiple births included 20.78% twins and 0.92% triplets and over. In oocyte donation, twins reached 28.93% and triplets 1.07%. Preterm deliveries reached 16.4% in singletons, 55.02% in twins and 76% in triplets. Perinatal mortality in 18,162 births was 23 per 1000 in singletons, 35 per 1000 in twins, and 36 per 1000 in high-order multiples. Elective single embryo transfer represented 2.63% of fresh transfers, with a 32.15% delivery rate per transfer. Elective double embryo transfer represented 23.74% of transfers, with a 41.03% delivery rate per transfer; 11,373 babies (62.6%) were singletons; 6398 (35.2%) twins, and 391 (2.2%), triplets and more. Given the effect of multiple births on prematurity, morbidity and perinatal mortality, reinforcing the existing trend of reducing the number of embryos transferred is mandatory.
我们从15个拉丁美洲国家的159个机构收集了关于辅助生殖技术（体外受精和卵胞浆内单精子注射[ICSI]、冷冻胚胎移植、卵母细胞捐赠、植入前基因诊断和生育力保存）的跨国数据。在体外受精-ICSI周期中，35至39岁女性进行的周期占41.34%，40岁及以上女性进行的周期占23.35%。排除全冷冻病例后，ICSI每次取卵的分娩率为25.05%，体外受精为27.41%。多胎妊娠包括20.78%的双胞胎和0.92%的三胞胎及以上。在卵母细胞捐赠中，双胞胎占28.93%，三胞胎占1.07%。单胎早产率为16.4%，双胞胎为55.02%，三胞胎为76%。18162例分娩中的围产期死亡率，单胎为每1000例23例，双胞胎为每1000例35例，高阶多胎为每1000例36例。选择性单胚胎移植占新鲜移植的2.63%，每次移植的分娩率为32.15%。选择性双胚胎移植占移植的23.74%，每次移植的分娩率为41.03%；11373名婴儿（62.6%）为单胎；6398名（35.2%）为双胞胎，391名（2.2%）为三胞胎及以上。鉴于多胎妊娠对早产、发病率和围产期死亡率的影响，必须加强现有的减少移植胚胎数量的趋势。
