Avaliação do percurso e desfecho de casais com infertilidade na consulta de um centro de Procriação Medicamente Assistida do SNS

• Autor(a) principal: Sobral,Catarina
• Data de Publicação: 2021
• Outros Autores: Sousa-Santos,Ricardo
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302021000300225
• topic: Assisted reproductive technology; Infertility; Live birth; Predictive characteristics.

Abstract Overview and Aims: There have been social and lifestyle changes, leading to 14% of couples who want to conceive being diagnosed with infertility. In some cases, Assisted Reproductive Technology (ART) is pursued. This study aimed to understand the course of couples being followed at the fertility consultation of an ART Centre and to establish predictive characteristics of success and cumulative live birth probabilities of the available treatments. Study design: Retrospective cohort. Population: Couples with infertility of the sphere of influence of a public hospital at the consultation of the Medically Assisted Reproduction Centre. Methods: It was collected clinical information regarding couples with infertility diagnosis, without previous treatments in a public ART Centre, who started being followed between January 2016 and June 2017. Results: 397 infertile couples were included, of which 47.6% had a live birth or got an ongoing evolutive pregnancy during the follow-up period (0 to 55 months), being 23.7% ART-related. There were significant differences (p<0.05) between couples with and without a live birth regarding female and male ages, antimullerian hormone concentration, number of children from previous female relationships, male smoking status, male ethnicity, congenital uterine malformation, polycystic ovary syndrome, early pregnancy loss, varicocele, couples whose men have neither medical nor surgical history and infertility causes. The logistic regression model concerning couples being followed at the fertility consultation showed that female age was the most relevant predictor of live birth. The cumulative live birth probability is 87.2% after 12 months of ovulation induction, 47.4% after 3 intrauterine inseminations and 60.6% after 3 in vitro fertilizations/intracytoplasmic sperm injections. Conclusions: It is of the utmost importance to increase social, medical and political awareness to achieve an earlier referral of these couples, a shorter waiting time between treatments and the most suitable treatment for each couple.