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The results of 14.872 procedures of Assisted Reproduction performed in 1999 by 93 centres belonging to the RED were informed. Moreover, a longitudinal analysis of the procedures performed between 1990 and 1999 was included. As in the previous years, Brazil and Argentine have contributed with the majority of the procedures of the area.
From the procedures performed in 1999, 28.3% corresponds to IVF, 44.5% to ICSI and 11.3% to assisted hatching, Soft/Tomi and combination of procedures. The techniques in which micromanipulation of gametes is included have increased from 3.7% of the 1993 procedures to 66.8% in 1999. The age distribution of the treated women shows that in 1999 the population of women aged < 35 was 66.5% and = 40 was 8.7%. In 1999, these numbers were 53.3% and 13.2% respectively. The fact the results do not vary according to the etiological diagnosis repeated this year, obtaining similar results in all categories.
To the first sight, the data do not suggest differences in the pregnancy rate when the transfer occurs after 48 hours, 72 hours or in blastocyst, and the number of cases is even lower to permit a rigorous analysis.
The clinical pregnancy rate (TEC) and births with liveborn by aspiration were 27.0% and 20.5% for IVF; 26.5% and 19.5% for ICSI, respectively. 12.604 transfers performed generated 3.845 liveborn (1.898 unique, 1.300 twins, 155 triplets and 92 quadruplets or more). In global terms, as in the interior of each diagnosis category, the TEC by aspiration decreases with the age of the woman. The effect of the age equally affects the implantation rate. Making a longitudinal comparison with the pregnancy rate by transference in IVF, we can observe that since 1995 a significant increase occurs each year. Equally, in 1999, the implantation rate in IVF is significantly higher than in 1995.
In global terms, the TEC continues increasing as the number of embryo transfer, as in IVF as in ICSI. The transference of more embryos does not represent an increase in the gestation rates, only in the multiple gestation.
The media of embryos transferred this year was 3.2.
It is important to point that by the first time it was possible to evaluate that: - The ovarian stimulation: in 69.6% of the cycles in which the FSH was used exclusively or combined with HMG. The agonist use continues being majority (89.9%), but, by the first time, cycles using antagonist (7.1%) appears. - IVF and ICSI results, according to the capacity of the centre: The pregnancy rate in IVF wasn't affected by the centre capacity. In opposition to what occurred in ICSI, where the pregnancy and implantation rates got by the centres in which 200 cycles or more was performed, was significantly higher.
Page 44, second paragraph, it should be: “From the 42 miscarriages with chromosomal evaluation, a total of 23 miscarriages with chromosomal abnormalities was reported, 09 in IVF (a), 01 in Cryopreservation (b) and 13 in ICSI (c)”. The detailed results are:
(a) - 1 miscarriage with 47, XX +4 - 1 miscarriage with 47, XX +6 - 1 miscarriage with 47, XX + 15 - 2 miscarriages with Trisomy 18 - 1 miscarriage with 47, XY + 22 - 1 miscarriage with 48, XY + 2 + 9 - 1 miscarriage with 69, XXX - 1 miscarriage with 92, XXXX (b) - 1 miscarriage with Trisomy 22 (c) - 3 miscarriages with 45, X (Syndrome of Turner) - 1 miscarriage with Trisomy 2 - 1 miscarriage with 47, XX + 16 - 1 miscarriage with 47, XY + 16 - 1 miscarriage with Trisomy 18 - 1 miscarriage with 47, XX + 21 (*) - 2 miscarriages with Trisomy 21 (*) - 1 miscarriage with Trisomy 22 - 1 miscarriage with 69, XXY - 1 miscarriage with Tetrasomy 21, 13 - (*) induced miscarriages