Frequency of a monochorionic pair in multiple gestations - Relationship to mode of conception
Frequency of a monochorionic pair in multiple gestations - Relationship to mode of conception
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DOI：
10.7863/jum.2001.20.7.757
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发表时间：
2001-07-01
影响因子：
2.3
通讯作者：
Ginsburg, E
中科院分区：
文献类型：
--
作者：
Chow, JS;Benson, CB;Ginsburg, E
Objective.确定受孕方式是否影响多胎妊娠中单绒毛膜妊娠的发生率。方法.我们的研究人群包括1998年5月至2000年4月期间在我们机构接受过早期超声检查的所有多胎妊娠妇女。将自然受孕的单绒毛膜妊娠频率与通过任何形式的辅助生殖技术和不同类型的辅助生殖技术实现的妊娠频率进行比较。结果我们的研究包括464例多胎妊娠，包括332例双胎妊娠，113例三胎妊娠，16例四胎妊娠和3例五胎妊娠。胎儿数量越多，辅助生殖技术导致妊娠的可能性越大（双胞胎72.6%，三胞胎84.1%，四胞胎92.8%，五胞胎100%; P <0.05，Fisher精确检验）。单绒毛膜对在自然妊娠中比在辅助生殖技术妊娠中更常见（28.2%对5.4%; P < .000001，卡方检验）。第5天囊胚移植体外受精后单绒毛膜对的频率（10.5%）是第3天卵裂期移植体外受精后单绒毛膜对频率（4.9%）的两倍，但差异无统计学意义（P = 0.24，Fisher精确检验）。结论.单绒毛膜双胞胎在自然受孕的双胞胎和辅助生殖技术产生的3个以上胎儿的高阶多胎妊娠中相对常见，但在辅助生殖技术产生的双胞胎和三胞胎中不常见。有一种趋势，即第5天囊胚移植后单绒毛膜对的频率高于第3天囊胚移植，但需要更大的研究人群来证实这一发现。
Objective. To determine whether the mode of conception affects the frequency of monochorionicity in multiple gestations. Methods. Our study population consisted of all women with multiple gestations who had a first-trimester sonogram at our institution between May 1998 and April 2000. The frequency of monochorionicity in pregnancies conceived naturally was compared with the frequency in pregnancies achieved via any form of assisted reproductive technology and among the different types of assisted reproductive technology. Results. Our study consisted of 464 multiple gestations comprising 332 twin, 113 triplet, 16 quadruplet, and 3 quintuplet pregnancies. The higher the fetal number, the more likely the pregnancy resulted from assisted reproductive technology (72.6% of twins, 84.1% of triplets, 92.8% of quadruplets, and 100% of quintuplets; P < .05, Fisher exact test). Monochorionic pairs were found more commonly in naturally conceived pregnancies than in those resulting from assisted reproductive technology (28.2% versus 5.4%; P < .000001, chi (2) test). The frequency of monochorionic pairs after in vitro fertilization with blastocyst transfer on day 5 (10.5%) was double the frequency from in vitro fertilization with cleavage stage transfer on day 3 (4.9%), but the difference was not statistically significant (P = .24, Fisher Exact test). Conclusions. Monochorionic pairs are relatively common in naturally conceived twins and in higher-order multiple gestations with more than 3 fetuses arising from assisted reproductive technology, but they are uncommon in twins and triplets arising from assisted reproductive technology. There is a trend toward a higher frequency of monochorionic pairs after day 5 blastocyst transfer than day 3 transfer but a larger study population is needed to confirm this finding.