Registro chileno de técnicas de reproducción asistida, 2011 / Chilean record of assisted reproduction techniques, 2011

Presentamos el Registro Chileno de Técnicas de Reproducción Asistida realizadas en el año 2011. Siete centros reportaron un total de 1.918 ciclos de reproducción asistida: 161 ciclos de fecundación in vitro (FIV), 1.266 ciclos de inyección intracitoplasmática de espermatozoides (ICSI), 325 ciclos de transferencia de embriones criopreservados, y 166 ciclos de transferencia de embriones producto de ovodonación. La tasa de parto por aspiración en ciclos de FIV fue 18,6 por ciento y en ciclos de ICSI fue 22,0 por ciento. La tasa de parto por transferencia embrionaria en ciclos de transferencia de embriones criopreservados fue 21,5 por ciento; en ciclos de transferencia de embriones producto de ovodonación fue 41,9 por ciento. La edad promedio de las mujeres sometidas a ciclos de IVF/ICSI fue 35,7 años (rango: 22-48 años). El 38 por ciento de los ciclos iniciados fue en mujeres <34 años. A diferencia de años anteriores, la media de embriones transferidos no presentó una disminución, estabilizándose en 2,1. La frecuencia global de parto múltiple en IVF/ICSI fue 24 por ciento; 23 por ciento gemelar y 1 por ciento parto triple y mayor. Concluimos que la tasa de parto de los ciclos de IVF/ICSI se mantiene relativamente estable en relación a años anteriores. Gracias a la criopreservación y la transferencia secuencial de toda la cohorte de embriones producidos, la frecuencia de partos triple descendió considerablemente. Sin embargo, la alta frecuencia de parto doble no ha experimentado ninguna disminución y debe ser el próximo desafío.

We present the Chilean Registry of Assisted Reproductive Technologies performed in 2011. For the first time this registry is performed on a case-by-case basis. Seven centres reported 1,918 cycles: 161 in vitro fertilisation cases (IVF), 1,366 intracytoplasmatic sperm injection cases (ICSI), 325 cryiopreserved embryo transfers, and 158 oocyte donation cycles. The delivery rate per oocyte pick up for IVF and ICSI cycles was 18.6 percent and 22.0 percent, respectively. The delivery rate per embryo transfers for cryopreserved embryo transfer and oocyte donation were 21.5 percent and 41.9 percent, respectively. The mean age of woman undergoing IVF/ICSI was 35.7 years (min 22 max 48 years); 38 percent of initiated cycles were performed in women aged <34 years. As in previous years, the mean number of embryos transferred declined slightly, reaching 2.1. The multiple delivery rate was 24 percent: 23 percent twin and 1 percent triplet and higher. In conclusion the delivery rate in IVF/ICSI cycles remains stable. Thanks to cryopreservation and posterior embryo transfer, the rate of triplet-delivery continues to diminish. However, the rate of twin delivery has not diminished, and remains a challenge.

Factors predicting the outcome of intracytoplasmic sperm injection for infertility.

BACKGROUND: Male factor abnormality is the cause of infertility in about 20%-40% of infertile couples. Assisted reproduction with intracytoplasmic sperm injection is the only treatment option for severe forms of andrological infertility. METHODS: We retrospectively analysed patients who had had intracytoplasmic sperm injection for male factor infertility. The clinical and laboratory factors that influenced the pregnancy rate were also analysed. RESULTS: One hundred and seventy-five cycles in 164 couples were analysed. The fertilization, cleavage and pregnancy rates were similar in the groups that had had intracytoplasmic sperm injection with epididymal, testicular or ejaculate sperm. Univariate analysis of the clinical variables showed progressive reduction in pregnancy rate with increase in the woman partner's age and body mass index, and presence of pelvic disease, but these were not statistically significant. The age of the woman was the most significant factor affecting the pregnancy rate after adjusting for body mass index and pelvic disease in the multivariate analysis (OR 0.26, 95% CI: 0.08-0.84, p=0.03). The oocyte number, embryo transfer number and transfer day had no significant influence on the outcome. CONCLUSION: The woman partner's age influences the success of assisted reproduction with intracytoplasmic sperm injection in male factor infertility. Thus, the chances of success are better if the couple seeks treatment at an early age.

Intracytoplasmic sperm injection procedure for infertility treatment in couples

A injeção intracitoplasmática de espermatozóide (ICSI) foi o procedimento aplicado em 68 pacientes com idade média de 34,7 anos. Foram realizadas as seguintes etapas: indução da ovulação; aspiração folicular; seleção dos oócitos e coleta de sêmen; injeção de espermatozóides e transferência dos embriões ao útero. Os resultados mostraram que 56 por cento dos problemas de infertilidade relacionam-se a fatores femininos. A maior freqüência de fatores masculinos e femininos que causaram infertilidade foram astenozoospermia (63 por cento) e fatores tubários (32,7 por cento), respectivamente. De um total de 695 oócitos aspirados, 453 (67,1 por cento) resultaram em zigotos com 2 pró-núcleos (2PN); 4 (0,55 por cento), 32 (4,42 por cento) e 2 (0,27 por cento) resultaram em zigotos 1PN, 3PN e 4PN, respectivamente. As taxas de gestação por ciclo e por transferência foram 25 por cento e 28,9 por cento, respectivamente. Nossos dados sugerem que a ICSI tem sido o método de escolha no tratamento da infertilidade devido a diversas etiologias, e os resultados mostraram que o sucesso nas taxas de fertilização tem aumentado as chances de gravidez