Without a doubt, the most significant “complication” of ART is the high rate of therapeutic failure (no pregnancy). Most people suffering from infertility see ART as their last chance of becoming mothers or fathers, and failure is experienced in a very complex way. For this reason, psychological and family support, as well as that of groups of people suffering from infertility are important help for people who cannot fulfill their desire to become parents.
Another complex but preventable complication is multiple pregnancy. Even though for many people the arrival of twins is considered an additional “grace”, a multiple gestation, mainly triplets and more, bears complications during pregnancy and after birth as a result of prematurity, and its implications during neonatal development. This complication can be prevented by transferring only one embryo at a time.
These conditions may be caused by transvaginal puncture, which consists of the introduction of a needle through the vagina into the ovaries to aspirate the follicles and retrieve the eggs. Both hemorrhage and infection are very infrequent complications and, at least in accredited centers, it occur in less than 1 to 2 per thousand procedures.
This condition is characterized by a wide spectrum of clinical and laboratory conditions with a disproportionate ovarian enlargement, associated to a change in blood vessel permeability. For this reason, fluid is often accumulated in the abdomen. The woman becomes distended, she feels very swollen. Most of these hyperstimulation cases are uncomfortable, but they spontaneously resolve with some bedrest. However, there are some cases, mainly in women suffering from a condition called “polycystic ovarian syndrome”, in which hyperstimulation may be out of control and require hospitalization. With the current knowledge and new available drugs to stimulate egg maturation, the prevalence of this condition, in its severe stage, is less than 1%. It is well known that, if pregnancy takes place, severe hyperstimulation is worsened. Therefore, when a woman is at a high risk of ovarian hyperstimulation syndrome, the embryos are frozen as it is known that a concomitant pregnancy can make the symptoms more severe. In this way, thanks to embryo freezing, the frozen embryo/s can be transferred in a deferred manner.
The Latin American Registry of Assisted Reproduction (RLA) thanks the 204 institutions accredited by REDLARA which, every year, report their data to RLA.
This voluntary and rigorous contribution makes it possible to generate a powerful database, which helps doctors and patients take decisions based on the best existing regional evidence.
This educational portal is the result of a collaborative activity between the Latin American Network of Assisted Reproduction (REDLARA), and University Diego Portales from Chile, which allow the link between the reproductive science and technology advances with the needs of people suffering from infertility and other forms of reproductive impairments.
We thank Dr. Ariel Ahumanda and Dr. Gustavo Martínez from Argentina for: images and videos of spontaneous in vitro fertilization, ICSI and PGT,
Dr. Roger Molinas from Paraguay for: videos of follicular aspiration and embryo transfer,
Dr. Javier Crosby from Chile for: images of different stages of in vitro embryo development,
Dr. Yasuyuki Mio from Japan for his video of in vitro embryo development.
We especially thank the industry for providing the financial support, which is so necessary to keep the Latin American registry as a pillar of this international cooperation, which today includes 16 countries and more than 200 collaborative institutions, from Mexico in the north to Chile in the far south.
