选择性单新鲜囊胚移植与先冻存随后移植均可提高年轻女性体外受精活产率并降低双胎妊娠率  

Elective transfer of single fresh blastocysts and later transfer of cryostored blastocysts reduces the twin pregnancy rate and can improve the in vitro fertilization live birth rate in younger women

作　　者：Henman M Catt J.W Wood T. R.P.S. Jansen 李跃萍 

机构地区：[1]Sydney IVF, Box 4384, Sydney, NSW 2001, Australia

出　　处：《世界核心医学期刊文摘（妇产科学分册）》2006年第5期23-24,共2页Core Journal in Obstetrics/Gynecology

摘　　要：To determine the extent to which embryo selection by blastulation and elective single blastocyst transfer, supported by efficient cryostorage of spare embryos, can reduce multiple pregnancies and maintain or improve on the live birth rate from IVF. Design: Prospective, nonrandomized cohort study. Setting: Sydney IVF, a private clinic in Australia. Patient(s): In vitro fertilization patients aged < 38 years with three or more usable blastocyst, recruited from April 2000 through December 2001, with pregnancies followed up until August 2004. Intervention(s): Blastocysts were cultured and cryostored with stage-specific culture medium and low oxygen conditions. Main Outcome Measure(s): Fetal heart-positive twin pregnancy rate and accumulating “ take-home baby” rate per retrieval leading to blastocyst transfer. Result(s): Among 121 women who elected single fresh blastocyst transfer (but who could elect to have two frozen blastocysts transferred at once), 79 (65.3% ) took home a baby, with a twin pregnancy rate of 7% . Among 285 women who chose two blastocysts for fresh transfer, 184 (64.2% ) took home at least one baby, with a twin pregnancy rate of 34% and five perinatal deaths. Conclusion(s): With technically appropriate blastocyst culture and freezing, and elective single blastocyst transfer in the fresh cycle, the overall multiple pregnancy rate can be reduced by > 75% , permitting in this series a slight increase in the chance of taking home a baby.To determine the extent to which embryo selection by blastulation and elective single blastocyst transfer, supported by efficient cryostorage of spare embryos, can reduce multiple pregnancies and maintain or improve on the live birth rate from IVF. Design: Prospective, nonrandomized cohort study. Setting: Sydney IVF, a private clinic in Australia. Patient(s): In vitro fertilization patients aged < 38 years with three or more usable blastocyst, recruited from April 2000 through December 2001, with pregnancies followed up until August 2004. Intervention(s): Blastocysts were cultured and cryostored with stage-specific culture medium and low oxygen conditions. Main Outcome Measure(s): Fetal heart-positive twin pregnancy rate and accumulating “ take-home baby” rate per retrieval leading to blastocyst transfer. Result(s): Among 121 women who elected single fresh blastocyst transfer (but who could elect to have two frozen blastocysts transferred at once), 79 (65.3% ) took home a baby, with a twin pregnancy rate of 7% . Among 285 women who chose two blastocysts for fresh transfer, 184 (64.2% ) took home at least one baby, with a twin pregnancy rate of 34% and five perinatal deaths. Conclusion(s): With technically appropriate blastocyst culture and freezing, and elective single blastocyst transfer in the fresh cycle, the overall multiple pregnancy rate can be reduced by > 75% , permitting in this series a slight increase in the chance of taking home a baby.

关 键 词：囊胚移植 活产率 体外受精 双胎妊娠 囊胚形成 取卵 受孕情况 多胎妊娠 胎心搏动 低氧条件 

分 类 号：R714.8[医药卫生—妇产科学]