IVF成功定义—基于Delphi法的中国专家意见  

Definition of IVF success:Chinese expert opinion based on Delphi method

作　　者：IVF成功定义专家组 李蓉[2] Expert Suggestions Group on the Definition of IVF Success;Li Rong

机构地区：[1]不详 [2]北京大学第三医院妇产科,北京100191

出　　处：《中华生殖与避孕杂志》2024年第9期887-897,共11页Chinese Journal of Reproduction and Contraception

基　　金：国家重点研发计划项目(2022YFC2702500, 2022YFC2705305)。

摘　　要：目的旨在采用Delphi法对体外受精(in vitro fertilization, IVF)成功的定义提出专家意见, 为临床实践提供参考依据。方法采用Delphi法对衡量IVF成功定义进行专家调查, 由8名专家基于相关文献制定陈述框架, 并通过会议讨论细化陈述内容, 形成陈述初始内容。通过发放调研问卷, 就陈述内容征询23名生殖专家意见。据专家反馈意见对陈述进行修改, 并再次发放问卷, 直至达成共识。结果共进行2轮问卷调查, 专家参与的积极程度分别为100%(23/23)和73.9%(17/23), 专家权威系数为0.895。就IVF成功定义相关的19条陈述达成共识, 主要包括:①IVF治疗的目标(1条陈述), 即安全地尽快获得单胎健康活产。②IVF成功的定义(13条陈述), 包括IVF治疗的有效性、安全性和效率的评估, 单个卵巢刺激周期2年内的累积活产率是衡量IVF治疗成功的绩效指标。衡量IVF成功应从以患者为中心角度出发, 结合患者的负担和满意度进行评价。③IVF成功的保障(3条陈述)。IVF治疗应遵循循证医学证据, 尽量避免在诊疗过程中实施未经证实的、患者获益不明确的治疗方案。辅助生殖机构应通过建立关键技术指标的监测并完善质控体系来优化治疗质量。④IVF成功的挑战(2条陈述)。取卵前取消周期和治疗周期失败后放弃继续治疗是IVF成功不可忽视的挑战。结论基于Delphi法, 结合生殖专家组的临床观点, 就IVF成功的定义形成了专家意见, 可作为临床指南的补充, 用于指导临床实践, 助力改善治疗结局。ObjectiveTo formulate expert opinion on definition of in vitro fertilization(IVF)success by a Delphi consensus,to provide a reference basis for clinical practice.MethodsChinese experts in assisted reproduction technology(ART)were surveyed using the Delphi method.Based on the literature related to IVF success,8 experts developed a framework of statements and items.A questionnaire was then distributed to 23 experts to canvas their opinions on these statements.If consensus was not achieved,the statement was revised and re-voted upon until a consensus was reached.ResultsIn the two rounds of questionnaire survey,the positive degree of expert participation was 100%(23/23)and 73.9%(17/23)respectively,and the coefficient of expert authority was 0.895.Consensus was reached for 19 statements related to the definition of IVF success,the most relevant of which are summarized as follows:1)Goal of IVF treatment(1 statement),attain a health live birth in the shortest possible time and with the lowest possible risks.2)Definition of IVF success(13 statements).Effectiveness,safety and efficiency of IVF treatment should be included in the definition of success,with the cumulative live birth rate per ovarian stimulation cycle in 2 years being a performance indicator of success,and IVF success should be measured from a patient-centered perspective,including the patient's burden and satisfaction.3)Assurance of IVF success(3 statements).IVF treatment should follow evidence-based guidelines and avoid implementing unverified treatment plans with unclear patient benefits during the diagnosis and treatment process.Assisted reproductive institutions should optimize treatment quality by establishing monitoring of key technical indicators and improving quality control systems.4)Hurdles of IVF success(2 statements).Cycle cancellation before oocyte pick-up and treatment discontinuation after failed cycles are hurdles of success with IVF.ConclusionThe opinions on the definition of IVF success was based on the joint input of reproductive expert p

关 键 词：受精 体外 成功率 累积活产率 

分 类 号：R714.8[医药卫生—妇产科学]