选择性靶向囊胚胚胎移植:优化ivf妊娠结果,同时最大限度地降低风险和副作用

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摘要

研究问题:单胚胎移植是一个合理的选择吗?设计:材料和方法:这是一项在单个试管婴儿中心进行的回顾性队列研究。这些患者包括96名使用卵子捐赠者的患者和92名使用自己的卵子的患者,总共188名接受体外受精- icsi的患者。结果:在接受捐赠卵子的96名患者中,59名妇女(61%)妊娠试验呈阳性,导致40例活产(每次妊娠68%)。另一方面,在92名接受自己卵子的患者中,34名患者(37%)在妊娠试验中呈阳性,导致15名活产(每次妊娠44%)。总的来说,在55个活产婴儿中,有24个是多胎妊娠。有趣的是,所有多胎妊娠都发生在年龄<35岁的患者中。结论:这些结果证实并加强了生殖学会的各种建议,即在囊胚期及以上阶段进行选择性单胚胎移植对于年龄小于38岁的患者,特别是使用年龄小于33岁的卵子供体的患者是可行的,同时可以获得相当高的成功单胎活产率。这是基于预测计算得出的,即每个卵子捐赠者妊娠的单胎活产率为42.5%,而使用自己卵子的患者每次妊娠的单胎活产率为28%。结论:Blastocyst及A级以上妊娠试验阳性患者生化阳性或临床阳性妊娠试验阳性率为63.7%,活产率为40.7%。而其他级别或发育阶段较低的囊胚患者的生化或临床妊娠阳性率为30.7%,活产率为10.7%。
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Selectively targeted blastocyst embryo transfer: optimizing ivf pregnancy results while minimizing risks and side effects
Research Question: Is single embryo transfer a reasonable option. Design: Material and methods: This is a retrospective cohort study conducted in a single IVF center. These patients consisted of 96 patients using egg donors and 92 patients using their own eggs for a total of 188 patients undergoing IVF-ICSI. Results: Among 96 patients who received donor eggs, 59 women (61%) were positive for pregnancy tests, resulting in 40 live births (68% per Pregnancy). On the other hand, of 92 patients who received their own egg, 34 patients (37%) were positive in terms of pregnancy tests, resulting in 15 live births (44% per pregnancy). Overall, of all 55 live births, 24 were multiple pregnancies. Interestingly, all multiple pregnancies occured in patients <35 years of age. All of these multiples resulted from the transfer of two blastocysts of grade A. Conclusion: These results corroborate and enhance the various reproductive society recommendations that a selective single embryo transfer at the blastocyst stage and above would be a feasible option in patients less than 38 years of age, especially in patients using egg donors younger than 33 years of age, while resulting in a reasonably high successful singleton live birth rate. This is based on the predicted calculation of a 42.5% singleton live birth per egg donor pregnancy, and a 28% singleton live birth per pregnancy for patients using their own eggs. Summary: Patients who had Blastocyst or above grade A had a 63.7% biochemical or clinical positive pregnancy test result and a 40.7% Live birth. Whilst, patients with blastocysts of other grades or lower stages of development, resulted in 30.7% positive biochemical or clinical pregnancy with 10.7% live birth.
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