Red Latinoamericana de Reproducción Asistida (REDLARA) (2023). RLA Annual Report 2020 (Latin American Registry of Assisted Reproduction). Red Latinoamericana de Reproducción Asistida.
Red Latinoamericana de Reproducción Asistida (REDLARA). RLA Annual Report 2020 (Latin American Registry of Assisted Reproduction). Red Latinoamericana de Reproducción Asistida; 2023.
Red Latinoamericana de Reproducción Asistida (REDLARA). RLA Annual Report 2020 (Latin American Registry of Assisted Reproduction). Red Latinoamericana de Reproducción Asistida, 2023.
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RRM Academy Synopsis
Latin American ART centers reported 12,778 deliveries in 2020
Latin American centers reported 87,732 initiated cycles that led to 12,778 deliveries in 2020. The regional registry gathered these data retrospectively from 188 institutions in 16 countries. About 1 out of 3 women treated were aged 40 or older. The report also compares outcomes by embryo transfer type, genetic testing and endometriosis.
Key Findings
Women aged 40 and older rose from 27% to 34% of women treated over seven years, while women aged 34 and younger fell from 31.7% to 24.7%.
Delivery rate per transfer was 29.0% after frozen and 23.9% after fresh transfer, significantly higher. Blastocyst transfers without genetic testing showed no significant difference (prevalence ratio 1.00; 95% CI 0.94–1.06).
After blastocyst transfer, delivery rate per transfer was 34.2% for elective single-embryo and 37.9% for elective double-embryo transfer, while multiple births rose from 1% to 30.5%.
Perinatal mortality was 7.7‰ in singletons, 24.4‰ in twins and 64.0‰ in triplets. Preterm birth occurred in 17.2%, 67.8% and 92.3% respectively.
Endometriosis appeared in 11,153 of 39,418 initiated fresh cycles (28.3%). Delivery rate per transfer after surgery for peritoneal endometriosis was 31.2 versus 24.1 for tubal and endocrine factors at ages 35–39 (p=0.0004).
Interpretation
The registry is a retrospective collection of reports from accredited institutions. The authors estimate the cycles that went unreported and name this a potential source of error. Comparisons by transfer type, genetic testing and diagnosis describe associations in pooled data. The authors note that without a randomized trial, their endometriosis finding cannot be certified. Delivery rates differ by what is counted: initiated cycles, retrievals or transfers. The authors attribute the fall in cycles and centers largely to pandemic closures. The authors state that the data used are confidential.
RRM Context
Restorative reproductive medicine seeks the cause of reduced fertility in both partners. For endometriosis, the surgical standard is excision, which treats the disease at its source. The registry records endometriosis as a primary or secondary diagnosis in 28.3% of initiated fresh cycles. ART proceeds without establishing why conception has not occurred.
Our editorial summary of this paper, not the article's abstract.
Key figures
Treatment activity, 2020
Measure
Value
Source
ART cycles per million inhabitants, Uruguay
558
Report text
ART cycles per million inhabitants, Argentina
490
Report text
ART cycles per million inhabitants, Panama
425
Report text
IVF and ICSI outcomes, 2020
Measure
Value
Source
Delivery rate per oocyte retrieval, ICSI cycles, excluding freeze-all cycles
14.8%
Report text
Delivery rate per oocyte retrieval, IVF cycles, excluding freeze-all cycles
15.6%
Report text
Embryo transfer practice, 2020
Measure
Value
Source
Frozen embryo transfers as a share of all embryo transfers
66.6%
Report text
Delivery rate per embryo transfer, frozen embryo transfer
29.0%
Report text
Delivery rate per embryo transfer, fresh embryo transfer, all ages
23.9%
Report text
Multiple births and perinatal outcomes, 2020
Measure
Value
Source
Multiple birth rate, elective single embryo transfer vs elective double embryo transfer
1% to 30.5%
Report text
Number of frozen embryo transfer deliveries included in analysis
6423
Supplementary Table 5
Number of fresh autologous transfer deliveries included in analysis
2661
Supplementary Table 5
Preterm birth rate, singleton births
17.2%
Report text
Preterm birth rate, twin births
67.8%
Report text
Fertility preservation, 2020
Measure
Value
Source
Share of women preserving fertility by oocyte vitrification who were age 38 or older
44.8%
Figure 14
Trends, 2020
Measure
Value
Source
Decrease in number of ART cycles, 2020 versus previous year
19,188
Report text
Decrease in number of babies born, 2020 versus previous year
8441
Report text
Our summary of the report's published figures, each citing its table, figure or section. The full report is at the publisher's link.
