Duarte-Filho Oscar Barbosa, Bianchi Paulo Homem de Mello, Lobel Alexandre Likier Steinberg, Peregrino Pedro Felipe Magalhães, Piccinato Carla de Azevedo, Podgaec Sérgio
Department of Gynecology and Obstetrics, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Human Reproduction Center Governador Mario Covas, Clinics Hospital, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Rev Bras Ginecol Obstet. 2019 Aug;41(8):493-499. doi: 10.1055/s-0039-1693680. Epub 2019 Aug 26.
To compare the Latin American and European assisted reproductive technology (ART) registries regarding data accessibility and quality, treatment utilization, effectiveness, safety, and quality of services.
We performed an ecological study using data from scientific publications of Latin American and European registries that report cycles initiated during 2013 (the most recent registries available until December of 2017). The summarized data are presented as frequencies, percentages, minimum-maximum values, and absolute numbers.
Reporting clinics and cycle treatments were unevenly distributed between the participating countries for both registries, although access to ART is 15 times greater in Europe. In Latin America, individual services participate voluntarily reporting started cycles until cancellation, birth or miscarriage, while in Europe it varied among countries. It makes the data available from Latin America more uniform, although lesser representative when compared with European ones, given that reporting is compulsory for most countries. The cumulative live birth rate was better in Latin America. Female age, use of intracytoplasmic sperm injection (ICSI), cycles with transfer of ≥ 3 embryos, as well as multiple pregnancy rates were greater in the Latin American Register of Assisted Reproduction (RLA, in the Portuguese acronym). Assisted reproductive technology complications, such as ovarian hyperstimulation syndrome, hemorrhage, and infections were also higher in Latin America, although they are extremely uncommon in both regions.
Both regions have points to improve in the quality of their reports. Latin America has produced a more uniform reporting, their clinical results are generally comparable and sometimes higher than the European ones. In contrast, the safety of the treatment was higher in Europe, with lower rates of complications, especially multiple pregnancies.
比较拉丁美洲和欧洲辅助生殖技术（ART）登记处的数据可及性与质量、治疗利用情况、有效性、安全性及服务质量。
我们进行了一项生态研究，使用拉丁美洲和欧洲登记处科学出版物中的数据，这些数据报告了2013年启动的周期（截至2017年12月可获取的最新登记数据）。汇总数据以频率、百分比、最小 - 最大值及绝对数呈现。
两个登记处参与国之间报告的诊所和周期治疗分布不均，尽管欧洲的ART可及性比拉丁美洲高15倍。在拉丁美洲，个体服务机构自愿报告开始的周期直至取消、分娩或流产，而在欧洲各国情况各异。这使得拉丁美洲的数据更为统一，尽管与欧洲数据相比代表性较低，因为大多数国家报告是强制性的。拉丁美洲的累积活产率更高。在拉丁美洲辅助生殖登记处（葡萄牙语首字母缩写为RLA）中，女性年龄、卵胞浆内单精子注射（ICSI）的使用、移植≥3个胚胎的周期以及多胎妊娠率更高。辅助生殖技术并发症，如卵巢过度刺激综合征、出血和感染在拉丁美洲也更高，尽管在这两个地区都极为罕见。
两个地区在报告质量方面都有需要改进之处。拉丁美洲的报告更为统一，其临床结果总体上具有可比性，有时高于欧洲。相比之下，欧洲治疗的安全性更高，并发症发生率更低，尤其是多胎妊娠。
