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  • Original Articles

    Assisted Reproductive Technologies in Latin America and Europe: a Comparative Analysis of Reported Databases for 2013

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):493-499

    Summary

    Original Articles

    Assisted Reproductive Technologies in Latin America and Europe: a Comparative Analysis of Reported Databases for 2013

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):493-499

    DOI 10.1055/s-0039-1693680

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    Abstract

    Objective

    To compare the Latin American and European assisted reproductive technology (ART) registries regarding data accessibility and quality, treatment utilization, effectiveness, safety, and quality of services.

    Methods

    We performed an ecological study using data from scientific publications of Latin American and European registries that report cycles initiated during 2013 (the most recent registries available until December of 2017). The summarized data are presented as frequencies, percentages, minimum-maximum values, and absolute numbers.

    Results

    Reporting clinics and cycle treatments were unevenly distributed between the participating countries for both registries, although access to ART is 15 times greater in Europe. In Latin America, individual services participate voluntarily reporting started cycles until cancellation, birth or miscarriage, while in Europe it varied among countries. It makes the data available from Latin America more uniform, although lesser representative when compared with European ones, given that reporting is compulsory formost countries. The cumulative live birth rate was better in Latin America. Female age, use of intracytoplasmic sperm injection (ICSI), cycles with transfer of ≥ 3 embryos, as well as multiple pregnancy rates were greater in the Latin American Register of Assisted Reproduction (RLA, in the Portuguese acronym). Assisted reproductive technology complications, such as ovarian hyperstimulation syndrome, hemorrhage, and infections were also higher in LatinAmerica, although they are extremely uncommon in both regions.

    Conclusion

    Both regions have points to improve in the quality of their reports. Latin America has produced a more uniform reporting, their clinical results are generally

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  • Original Article

    One Plus One is Better than Two: An Approach Towards a Single Blastocyst Transfer Policy for All IVF Patients

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(6):578-585

    Summary

    Original Article

    One Plus One is Better than Two: An Approach Towards a Single Blastocyst Transfer Policy for All IVF Patients

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(6):578-585

    DOI 10.1055/s-0042-1743096

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    Abstract

    Objective

    It is known that the single embryo transfer (SET) is the best choice to reduce multiples and associated risks. The practice of cryopreserving all embryos for posterior transfer has been increasingly performed for in vitro fertilization (IVF) patients at the risk of ovarian hyperstimulation syndrome or preimplantation genetic testing for aneuploidy. However, its widespread practice is still controverse. The aim of this study was to evaluate how effective is the transfer of two sequential SET procedures compared with a double embryo transfer (DET) in freeze-only cycles.

    Methods

    This retrospective study reviewed 5,156 IVF cycles performed between 2011 and 2019, and 506 cycles using own oocytes and freeze-only policy with subsequent elective frozen-thawed embryo transfers (eFET) were selected for this study. Cycles having elective SET (eSET, n = 209) comprised our study group and as control group we included cycles performed with elective DET (eDET, n = 291). In the eSET group, 57 couples who had failed in the 1st eSET had a 2nd eFET, and the estimated cumulative ongoing pregnancy rate was calculated and compared with eDET.

    Results

    After the 1st eFET, the ongoing pregnancy rates were similar between groups (eSET: 35.4% versus eDET: 38.5%; p =0.497), but the estimated cumulative ongoing pregnancy rate after a 2nd eFET in the eSET group (eSET + SET) was significantly higher (48.8%) than in the eDET group (p < 0.001). Additionally, the eSET +SET group had a 2.7% rate of multiple gestations, which is significantly lower than the eDET group, with a 30.4% rate (p < 0.001).

    Conclusion

    Our study showed the association of freeze-only strategy with until up to two consecutive frozen-thawed eSETs resulted in higher success rates than a frozenthawed DET, while drastically reducing the rate of multiple pregnancies.

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    One Plus One is Better than Two: An Approach Towards a Single Blastocyst Transfer Policy for All IVF Patients

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