Assisted reproductive technologies in Latin America: the Latin American Registry, 2022.

Abstract

Research question: What are the trends and impact of ART interventions on the effectiveness and safety of ART performed in Latin America during 2022.

Design: Retrospective collection of cycle-based multinational data obtained from ART procedures performed by 204 accredited institutions in 16 countries.

Results: In total 123,265 initiated cycles resulted in 19,663 deliveries and 22,203 births. ART utilization showed great variability, from 643.3 cycles/million inhabitants in Uruguay to 28.8 in Guatemala. In autologous cycles, the proportion of women ≥40 years represents 35.1% of cycles while women <34 years represents only 18.8%. Nonetheless, the proportion of single embryo transfer (SET) increased from 42.4% in 2021 to 47.3% in 2022. Out of 22,203 babies born, 77.4% were singletons, 21.7% twins and 0.9% triplets or more. ICSI represented 85.4% of fertilization techniques and blastocyst transfer increased from 79.3% in 2021 to 85.3% in 2022. The delivery rate after fresh blastocyst elective SET (32.6%) was significantly higher than after the transfer of one FET from freeze-all cycle (25.2%) (p=0.0001). The number of aspirations leading to preimplantation genetic testing has increased 2.6 times in 6 years, and significantly increased delivery rates/transfer (p≤0.008) and reduced miscarriage at all ages (p≤0.004) in autologous cycles, but not in oocyte donation cycles. Delivery rates after fresh transfer of embryos from vitrified-warmed donated oocytes, generated similar outcome to FET/OD (p=0.5621). Perinatal mortality increased from 7.5‰ in singletons to 22.8‰ in twins.

Conclusion: Systematic collection of cycle-based multinational data contributes to cooperative sustained development and helps implement evidence-based reproductive decisions.