Abstract
ObjectiveWhat 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?.DesignRetrospective collection of multinational data including epidemiology and outcomes of ART performed between 1990 and 2018.ResultsOver 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.ConclusionsThe 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.
Highlights
In this report, we celebrate the 30th anniversary of the Latin American Registry of Assisted Reproduction (RLA), which for the past 25 years has been part of the Latin American Network of Assisted Reproduction (REDLARA).In 1990, for the first time, 19 centres from eight countries (Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, Panama and Venezuela) voluntarily reported the outcomes of treatment with assisted reproductive technologies (ART) to a centralized multinational organization
The same applies to the comparison of live births after frozen embryo transfer (FET) resulting from an unsuccessful fresh cycle as compared with freeze-all cycles where the best embryos are cryopreserved for delayed transfer
The terminology used by RLA refers to definitions implemented by ICMART and first published in 2006 (Zegers-Hochschild et al, 2006), followed later by ‘The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) Revised Glossary on assisted reproductive technology (ART) Terminology, 2009’ (Zegers-Hochschild et al, 2009a, 2009b), further translated into Spanish and Portuguese in compliance with WHO regulations
Summary
We celebrate the 30th anniversary of the Latin American Registry of Assisted Reproduction (RLA), which for the past 25 years has been part of the Latin American Network of Assisted Reproduction (REDLARA).In 1990, for the first time, 19 centres from eight countries (Argentina, Brazil, Chile, Colombia, Ecuador, Mexico, Panama and Venezuela) voluntarily reported the outcomes of treatment with assisted reproductive technologies (ART) to a centralized multinational organization. The forms for data collection were adapted from those developed by the International Working Group of Registers in Assisted Reproduction ( the International Committee for Monitoring Assisted Reproductive Technologies (ICMART). Over the years, these forms have been modified many times in order to comply with regional interests and the incorporation of new technology. The same applies to the comparison of live births after frozen embryo transfer (FET) resulting from an unsuccessful fresh cycle as compared with freeze-all cycles where the best embryos are cryopreserved for delayed transfer With this cycle-based registry, centres have a greater armamentarium to examine their strengths as well as their weaknesses
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