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.
Unit of Reproductive Medicine Clínica Las Condes, Lo Fontecilla 441, Santiago, Chile; Latin American Network of Assisted Reproduction (REDLARA), Plaza Independencia 811 Montevideo, Uruguay.
Reprod Biomed Online. 2018 Dec;37(6):685-692. doi: 10.1016/j.rbmo.2018.08.026. Epub 2018 Oct 6.
What was the utilization, effectiveness and safety of assisted reproductive technologies (ART) performed in Latin American countries during 2015, and what were the regional trends?
Retrospective collection of multinational data on assisted reproduction techniques (IVF and intracytoplasmic sperm injection [ICSI], frozen embryo transfer, oocyte donation, preimplantation genetic testing and fertility preservation), from 175 institutions in 15 Latin American countries.
In total, 41.25% of IVF/ICSI cycles were performed in women aged 35-39 years, and 28.35% in women aged ≥40 years. After removing freeze-all cycles, delivery rate per oocyte retrieval was 21.39% for ICSI and 24.29% for IVF. Multiple births included 19.58% twins and 0.95% triplets and higher. In oocyte donation, delivery rate per transfer was 36.77%, with a twin and triplet rate of 27.65% and 1.06%, respectively. Overall, preterm deliveries reached 17.38% in singletons, 64.94% in twins and 98.41% in triplets. Perinatal mortality in 14,936 births and 18,391 babies born was 10.5 per 1000 in singletons, 17.9 per 1000 in twins, and 57.1 per 1000 in high-order multiples. Elective single embryo transfer represented 3.11% of fresh transfers, with a 31.78% delivery rate per transfer. Elective double embryo transfer represented 23.3% of transfers, with a 37.79% delivery rate per transfer. Out of 18,391 babies born, 63.22% were singletons, 34.4% twins, and 2.38% triplets and higher.
Given the effect of multiple births on prematurity, morbidity and perinatal mortality, reinforcing the existing trend of reducing the number of embryos transferred remains mandatory.
2015 年拉丁美洲国家使用辅助生殖技术（ART）的情况如何？有效性和安全性如何？有哪些地区趋势？
回顾性收集来自拉丁美洲 15 个国家的 175 个机构的辅助生殖技术（体外受精和胞浆内精子注射[ICSI]、冷冻胚胎移植、卵母细胞捐赠、植入前遗传学检测和生育力保存）的多国数据。
在总共 41.25%的 IVF/ICSI 周期中，35-39 岁的女性进行了 28.35%的 IVF/ICSI 周期，40 岁以上的女性进行了 28.35%的 IVF/ICSI 周期。在去除全部冷冻周期后，每个卵母细胞回收的活产率为 ICSI 为 21.39%，IVF 为 24.29%。多胎妊娠包括 19.58%的双胞胎和 0.95%的三胞胎及以上。在卵母细胞捐赠中，每次转移的活产率为 36.77%，双胞胎和三胞胎的比例分别为 27.65%和 1.06%。总的来说，单胎早产率为 17.38%，双胞胎早产率为 64.94%，三胞胎早产率为 98.41%。在 14936 例分娩和 18391 例活产婴儿中，1000 例单胎的围产期死亡率为 10.5，1000 例双胎的围产期死亡率为 17.9，1000 例多胎的围产期死亡率为 57.1。选择性单胚胎移植占新鲜移植的 3.11%，每次移植的活产率为 31.78%。选择性双胚胎移植占转移的 23.3%，每次转移的活产率为 37.79%。在 18391 例活产婴儿中，63.22%为单胎，34.4%为双胞胎，2.38%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，减少胚胎移植数量的现有趋势仍然是强制性的。
