Dados do Trabalho

Title

Success and safety rates of techniques used in assisted human reproduction treatment.

Objective

The use of Assisted Human Reproduction (AHR) techniques is increasing, since in recent years there has been a popularization of family planning, greater knowledge about the possibilities of treating AHR, and an increase in research that has demonstrated the success of the procedures. Although considered safe, these techniques may present a percentage of failure resulting in miscarriages or congenital malformations, and these alterations constitute a vast field to be investigated. In this sense, the objective of this study was to evaluate the success and safety rates regarding the use of Assisted Human Reproduction techniques, based on the medical records of patients treated at the Assisted Reproduction Center (CRA) of the Januário Cicco Maternity School, Natal-RN, Brazil

Methods

Upon approval by the UFRN Research Ethics Committee, the medical records of patients who consented to access data regarding the care they received at the CRA were analyzed. From an initial sample of 280 medical records, those whose patients dropped out or had not completed their treatment at the time of data collection, who had spontaneous pregnancies, who had a negative bHCG or who only performed fertility preservation were excluded; since the central objective of the study requires patients who, obligatorily, had positive bHCG from assisted reproduction treatment. Thus, the final sample number of this study was 89 patients. Biometric and clinical data were collected, such as body mass index (BMI), age, marital infertility factor present, AHR technique used, type of embryo transfer performed and characteristics of oocytes and embryos. A total of 13 variables were obtained, which were investigated for the existence or not of an association with the appearance of twin pregnancies, miscarriages, or congenital malformations, using the chi-square test or logistic regression

Results

Among the analyzed variables, 12 showed no significant association with twin pregnancy or miscarriage, which were: the type of contraception used; the BMI; maternal age; as well as the type of pregnancy obtained (single or twin); the history of abortion; the number of oocytes and embryos obtained; the AHR technique used; the type of infertility (primary or secondary), the presence of female or male infertility, and the infertility factor (whether female or male). On the other hand, the type of embryo transfer performed showed a significant association with the appearance of abortion, in which the fresh transfer had a higher number of abortions as a result (X²(2)=9.723 and p=0.008). Of the medical records that made up the sample of this study, only one reported the occurrence of congenital malformation. In this case, the technique of in vitro fertilization (IVF) and fresh embryo transfer had been used. The patient was overweight, primary infertility, 35 years old, and had no history of previous miscarriages.

Conclusion

This study demonstrated the independence of the results of twin pregnancies and the number of abortions with the AHR procedures; and above all, the very low (or almost non-existent) relationship between these treatments and the occurrence of congenital malformations, reinforcing safety in the execution of assisted reproduction techniques for the health of the offspring. While most of the analyzed variables had no influence on the gestational complications reported in this study, the type of embryonic transfer performed was relevant in the abortion results, so that fresh transfers were associated with higher abortion rates. We also emphasize the need for further studies that investigate in depth the relationships between these variables, always focusing on the health of the offspring to be obtained, and based on the ethical principles that regulate RHA techniques and procedures

Keywords

Infertility; Twin Pregnancy; Abortion; Malformations.