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. 2021 Oct 4;25(4):617-639.
doi: 10.5935/1518-0557.20210055.

Celebrating 30 years of ART in Latin America; and the 2018 report

Fernando Zegers-Hochschild  1   2 , Javier A Crosby  1 , Carolina Musri  1 , Maria do Carmo Borges de Souza  3 , A Gustavo Martínez  4 , Adelino Amaral Silva  5 , José María Mojarra  6 , Diego Masoli  1 , Natalia Posada  7
Affiliations

Celebrating 30 years of ART in Latin America; and the 2018 report

Fernando Zegers-Hochschild et al. JBRA Assist Reprod. .

Abstract

Objective: What are the trends in patient characteristics, effectiveness and safety of assisted reproductive technology (ART) performed in Latin America over the past three decades, as well as the detailed outcomes of procedures initiated in 2018?.

Design: Retrospective collection of multinational data including epidemiology and outcomes of ART performed between 1990 and 2018.

Results: Over these 30 years we report 955,117 initiated cycles, 191,191 deliveries and 238,045 live births. In 1990, 66.5% of women were ≤34 years and 8.7% ≥40 years; in 2018, 26.4% of women were ≤34 years and 32.0% were ≥40 years. In 1990, 60.4% of transfers included ≥3 embryos, falling to 13.5% in 2018, and single embryo transfer (SET) increased from 13.8% to 30.4% between 1990 and 2018. Delivery rate per fresh transfer increased from approximately 17% in the 1990s to 25% in 2018, with a meaningful drop in high-order multiples, from 5-9% in the 1990s to 0.4% in 2018. This drop is associated with increasing use of frozen embryo transfer (FET) (57% in 2018) compared with 10% in 2000. In 2018, delivery rate in FET was 28.3%, reaching 31.2% in freeze-all cycles; and the cumulative live birth rate (fresh + FET) was 41.9%. Elective SET also increased, from 0.9% in 2010 to 10% in 2018. The delivery rate in elective SET (31.7%) was only 5.4% lower than elective double embryo transfer (DET) (37.1%); however, multiple births increased from 2.1% to 25.5% twins and 0.4% triplets in elective DET.

Conclusions: The Latin American Registry of Assisted Reproduction (RLA) celebrates 30 years of voluntary reporting from a total of nearly 200 centres in 15 countries. This South-South Cooperation network has proven to be an efficient and safe system for technological transfer and regional growth.

Keywords: 30 years' trend analysis; Latin American Registry of ART; efficacy and perinatal outcome; safety.

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Figures

Figure 1
Figure 1
Database available at the Latin American Registry of Assisted Reproduction from January 1990 to September 2019.
Figure 2
Figure 2
Age distribution of women for assisted reproductive technology (ART) cycles initiated between 1990 and 2018.
Figure 3
Figure 3
Distribution of embryos transferred in fresh IVF/intracytoplasmic sperm injection (ICSI) cycles between 1990 and 2018. DET = double embryo transfer; ET = embryo transfer; SET = single embryo transfer; TET = triple embryo transfer.
Figure 4
Figure 4
Delivery rate by fresh embryo transfer in Latin America between 1990 and 2018.
Figure 5
Figure 5
Delivery rate after fresh IVF/intracytoplasmic sperm injection (ICSI) in women <35 years between 1994 and 2018.
Figure 6
Figure 6
Proportion of births as singletons, twins and triplets or more between 1990 and 2018.
Figure 7
Figure 7
Number of frozen embryo transfer (FET) cycles and mean number of embryos per transfer in Latin America between 1996 and 2018.
Figure 8
Figure 8
Proportion of FET and fresh transfers in Latin America between 1996 and 2018.
Figure 9
Figure 9
Delivery rate per embryo transfer in fresh and frozen embryo transfers in Latin America between 2000 and 2018.
Figure 10
Figure 10
Proportion of elective single (eSET) and elective double (eDET) embryo transfers in Latin America between 2010 and 2018.
Figure 11
Figure 11
Delivery rate after elective single (eSET) and elective double (eDET) embryo transfers in Latin America between 2010 and 2018.
Figure 12
Figure 12
Number of cycles according to sequence of events that take place from the start of an assisted reproductive technology (ART) cycle until embryos are transferred in fresh, oocyte donation and frozen embryo transfer cycles in Latin America in 2018.
Figure 13
Figure 13
Utilization of assisted reproductive technology (ART) by country: estimated total number of cycles performed per million inhabitants in 2018.
Figure 14
Figure 14
Delivery rate per embryo transfer (ET) in IVF/intracytoplasmic sperm injection (ICSI) and oocyte donation (OD) cycles according to the age of the female partner in Latin America in 2018.
Figure 15
Figure 15
Delivery rate (DR) and cumulative delivery rate (cDR) per embryo transfer (ET) in IVF/intracytoplasmic sperm injection (ICSI) cycles according to the age of the female partner in Latin America in 2018.
Figure 16
Figure 16
Number of live births by country reported to the Latin American Registry of Assisted Reproduction (RLA) between 1990 and September 2019.
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