Zegers-Hochschild Fernando, Crosby Javier A, Musri Carolina, Petermann-Rocha Fanny, Martinez Gustavo, Nakagawa Hitomi, Morente Carlos, Roque Armando, Palma-Govea Ana
Program of Ethics and Public Policies in Human Reproduction, Faculty de Medicine, University Diego Portales, Santiago, Chile.
Unit of Reproductive Medicine, Clínica Las Condes, Santiago, Chile.
JBRA Assist Reprod. 2025 Mar 12;29(1):167-190. doi: 10.5935/1518-0557.20240107.
What are the trends and impact of new technologies on the effectiveness and safety of assisted reproductive technology (ART) performed in Latin America during 2021?
This was a retrospective collection of cycle-based multinational data obtained from ART procedures performed by 204 accredited institutions in 16 countries.
In total 127,351 initiated cycles resulted in 20,032 deliveries and 22,708 births. ART utilization showed great variability, from 623.5 cycles/million inhabitants in Uruguay to fewer than 35 in Guatemala and El Salvador. The proportion of women aged ≥40 years increased to 35.8%, while that of women ≤34 years dropped to 23.9%. Nonetheless, the proportion of single-embryo transfers (SET) increased from 11.9% in the previous decade to 42.4% in 2021. Of 22,708 babies born, 76.8% were singletons, 22.3% twins and 1.0% triplets or more. Intracytoplasmic sperm injection represented 84.5% of fertilization techniques, and blastocyst transfer increased from 49.6% in 2016 to 79.3% in 2021. The delivery rate after fresh blastocyst elective SET was significantly higher than after the transfer of one frozen embryo from a freeze-all cycle (p<0.0001). The number of aspirations leading to preimplantation genetic testing has increased 2.8 times in 5 years and significantly increased delivery rates/transfer at all ages, including in oocyte donation (p≤0.002), and reduced miscarriage in women ≥35 years old. In oocyte donation, delivery rates after the fresh transfer of embryos from vitrified-warmed oocyte cycles generated similar outcomes to frozen embryo transfer. Perinatal mortality increased from 7.7 ‰ in singletons to 21.3 ‰ in twins.
The systematic collection of cycle-based multinational data contributes to cooperative sustained development and helps implement evidence-based reproductive decisions.
2021年新技术对拉丁美洲辅助生殖技术（ART）有效性和安全性的趋势及影响如何？
这是一项基于周期的多国数据回顾性收集，数据来自16个国家204家认可机构实施的ART程序。
总计127351个起始周期产生了20032次分娩和22708例出生。ART利用率差异很大，从乌拉圭的每百万居民623.5个周期到危地马拉和萨尔瓦多的不足35个周期。40岁及以上女性的比例增至35.8%，而34岁及以下女性的比例降至23.9%。尽管如此，单胚胎移植（SET）的比例从过去十年的11.9%增至2021年的42.4%。在22708例出生婴儿中，76.8%为单胎，22.3%为双胞胎，1.0%为三胞胎或更多。卵胞浆内单精子注射占受精技术的84.5%，囊胚移植从2016年的49.6%增至2021年的79.3%。新鲜囊胚选择性SET后的分娩率显著高于冻存全胚周期中一个冷冻胚胎移植后的分娩率（p<0.0001）。导致植入前基因检测的取卵次数在5年里增加了2.8倍，且各年龄段的分娩率/移植率均显著提高，包括在卵子捐赠中（p≤0.002），并降低了35岁及以上女性的流产率。在卵子捐赠中，玻璃化冷冻卵子周期新鲜胚胎移植后的分娩率与冷冻胚胎移植相似。围产期死亡率从单胎的7.7‰增至双胞胎的21.3‰。
基于周期的多国数据的系统收集有助于合作持续发展，并有助于实施基于证据的生殖决策。
