非洲辅助生殖技术：非洲辅助生殖技术网络和注册处，2020 年。

Assisted reproductive technologies in Africa: The African Network and Registry for ART, 2020.

机构信息

Department of Obstetrics and Gynaecology, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.; African Network and Registry for Assisted Reproductive Technology..

出版信息

Reprod Biomed Online. 2024 Nov;49(5):104353. doi: 10.1016/j.rbmo.2024.104353. Epub 2024 Jul 3.

DOI:10.1016/j.rbmo.2024.104353

PMID:39305801

Abstract

RESEARCH QUESTION

What were the utilization, effectiveness and safety of assisted reproductive technology (ART) in Africa during 2020?

DESIGN

Cross-sectional, cycle-based and retrospective summary data were collected from voluntarily participating ART centres.

RESULTS

During 2020, 37,063 ART procedures were reported by 67 centres in 15 countries. Autologous fresh transfers were predominant at 65.0%, whereas autologous frozen embryo transfers (FET) represented 26.2% and oocyte donation cycles remained less than 10%. Women undergoing autologous fresh embryo transfer had a mean age of 34.9 years and received a mean number of 2.4 embryos per transfer. The clinical pregnancy rate (CPR) per embryo transfer was 37.3% after fresh embryo transfer and 37.8% after frozen embryo transfer. The cumulative CPR per aspiration was 41.9% in autologous cycles. Most ART procedures resulted in a multiple delivery rate above 20%. After autologous ART, multiples were predominantly born preterm (twin and triplet deliveries 59.5% versus singleton 21.9% born before 37 weeks), with a substantially increased perinatal mortality compared with ART singletons (59.0‰ versus 22.2‰). Cycle-based data documented that elective single embryo transfer (eSET) provides the optimal balance of effectiveness (eSET CPR per embryo transfer 36.7%) and safety.

CONCLUSION

This fourth report of the African Network and Registry for ART provides real-world evidence of ART utilization, practices and outcomes in Africa, which is relevant to many stakeholders. It critically informs and represents regional ART development based on national, regional and global cooperation.

摘要

研究问题

2020 年非洲辅助生殖技术（ART）的利用情况、有效性和安全性如何？

设计

从自愿参与的 ART 中心收集基于周期的回顾性总结数据。

结果

2020 年，15 个国家的 67 个中心报告了 37063 个 ART 周期。自体新鲜胚胎移植占主导地位，为 65.0%，而自体冷冻胚胎移植（FET）占 26.2%，卵母细胞捐赠周期仍不到 10%。接受自体新鲜胚胎移植的女性平均年龄为 34.9 岁，每次移植平均接受 2.4 个胚胎。新鲜胚胎移植后的临床妊娠率（CPR）为 37.3%，冷冻胚胎移植后的 CPR 为 37.8%。自体周期的累积 CPR 每抽吸为 41.9%。大多数 ART 周期的多胎分娩率超过 20%。在自体 ART 后，多胎妊娠主要早产（双胞胎和三胞胎分娩 59.5%，而 singleton 21.9%在 37 周前出生），与 ART singleton 相比，围产期死亡率显著增加（59.0‰对 22.2‰）。基于周期的数据记录表明，选择性单胚胎移植（eSET）提供了有效性（eSET CPR 每胚胎移植 36.7%）和安全性的最佳平衡。