Risk factors for twin pregnancy in women undergoing double cleavage embryo transfer.
Risk factors for twin pregnancy in women undergoing double cleavage embryo transfer.
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双卵裂胚胎移植后双胎妊娠的危险因素。
DOI：
10.1186/s12884-022-04606-1
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发表时间：
2022-03-29
影响因子：
3.1
通讯作者：
Zhang D
中科院分区：
文献类型：
--
作者：
Chen P;Hu KL;Jin J;Chen R;Xu Q;Zhao W;Zhang R;Xing L;Zhu Y;Zhang D
在传统的体外受精(IVF)策略中，人们使用两个或两个以上的胚胎移植来提高活产成功率，但代价是增加了多胎妊娠的风险和不良的围产儿结局。关于选择性单胚胎移植还是双胚胎移植的决定仍然没有定论。本研究的目的是探讨体外受精中双胎妊娠的危险因素。于2010年1月至2018年12月在浙江大学女子医院移植了两个卵裂期胚胎的首次新鲜试管受精周期的参与者被纳入这项回顾性队列研究。主要结果是双胎分娩。次要结果包括早产和低出生体重，15,459名妇女可用于最终分析，其中1,511名妇女导致双胞胎分娩，4,788名妇女单胎分娩。年龄超过35岁的女性与年龄小于或等于35岁的女性相比，双胞胎妊娠率降低(9.5%比25.1%，ARR = 为0.38(0.27。0.55))。不良类型的子宫内膜与双胎妊娠率降低相关(19.2%比27.5%，ARR = 0.75(0.58。0.96))。两个优质胚胎移植的双胞胎妊娠率显著高于一个优质胚胎或无优质胚胎(26%比12.8%比9.3%，ARR = 0.56(0.45)。0.70)，ARR = 0.44(0.26.0.74))。年龄超过35岁的女性和没有或有一个优质胚胎供移植与低出生体重率和早产儿的减少有关。年龄在35岁以上、子宫内膜类型较差、有一个优质胚胎或没有优质胚胎的妇女，双胞胎妊娠率降低。网上版载有补充材料，可在10.1186/s12884-022-04606-1查阅。
Two or more embryo transfers have been used to increase the success rate of live birth in traditional in vitro fertilization (IVF) strategy at the expense of increased risks of multiple pregnancy and adverse perinatal outcomes. The decision regarding the elective single embryo transfer or double embryo transfer remains inconclusive. The aim of this study was to investigate the risk factors for twin pregnancy in IVF. Participants who underwent their first fresh IVF cycle where two cleavage stage embryos were transferred in Women’s Hospital of Zhejiang University between January 2010 and December 2018 were included in this retrospective cohort study. The primary outcome was twin delivery. Secondary outcomes included preterm birth and low birth weight Fifteen thousand four hundred fifty-nine women were available for final analysis, in which 1511 women resulted in twin delivery and 4788 women had singleton delivery. Female age over 35 was associated with reduced rates of twin pregnancy compared with female age at or less than 35 (9.5% vs 25.1%, aRR = 0.38 (0.27. 0.55)). Poor-type endometrium was associated with reduced rates of twin pregnancy (19.2% vs 27.5%, aRR = 0.75 (0.58. 0.96)). Two good-quality embryos for transfer was associated with significantly higher rates of twin pregnancy compared with one good-quality or none good-quality embryo (26% vs 12.8% vs 9.3%, aRR = 0.56 (0.45. 0.70), aRR = 0.44(0.26. 0.74)). Female age over 35 and none or one good-quality embryo for transfer were associated with reduced rate of low birth weight and preterm birth. Women with age over 35, poor-type endometrium, one good-quality embryo or none good-quality embryo were associated with reduced rate for twin pregnancy. The online version contains supplementary material available at 10.1186/s12884-022-04606-1.
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