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19 - ART Surveillance in Latin America

from Section 4 - Global Variations in ART Surveillance

Published online by Cambridge University Press:  14 June 2019

Dmitry M. Kissin
Affiliation:
Centers for Disease Control and Prevention, Atlanta
G. David Adamson
Affiliation:
Fertility Physicians of Northern California, Palo Alto
Georgina Chambers
Affiliation:
National Perinatal Epidemiology and Statistics Unit, University of New South Wales, Sydney
Christian De Geyter
Affiliation:
University Hospital Basel
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Summary

IUI is often the first intervention offered for unexplained or mild to moderate male infertility and appears to be a safe method to prevent HIV transmission. Pregnancy and delivery rates per cycle remained stable for years. Factors influencing IUI results and studies evaluating if first line IVF rather than IUI could be a better option for couples with unexplained or mild male infertility will be discussed.Increased risks compared to spontaneous conceptions have been described. However, data on comparison with IVF is limited and points to similar or lower perinatal risks. Multiple pregnancies are responsible for most of perinatal morbidities and are dependent on the use and aggressiveness of ovarian stimulation. Cost efficiency appears to be influenced by the indication, associated medications and perinatal complications mainly related to multiple pregnancies. While currently IUI with ovarian stimulation seems cost-effective, further studies are needed to confirm it in settings with advanced ART techniques.

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Publisher: Cambridge University Press
Print publication year: 2019

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